Abstract
Abstract: :
Purpose:To investigate health–related quality of life (HRQOL) in patients with age related macular degeneration (ARMD) in a longitudinal study. We present the first three–year follow–up of HRQOL using the National Eye Institute Visual Function Questionnaire (NEI–VFQ) to assess self–reported visual impairment and functioning. Methods:In a prospective study we included patients with occult choroidal neovascularisation (CNV) secondary to ARMD and visual acuity (VA) of 0.25 or better and no other ocular disease. Examinations included ETDRS visual acuity, binocular ophthalmoscopy, fluorescein and ICG angiography, color fundus photography and the German versions of the SF–36 and NEI–VFQ. The NEI–VFQ has 12 subscales: General Health; general vision; pain; near, peripheral, colour, and distance vision; driving; the vision–specific subscales role difficulties, dependency, social function, mental health. Higher scales are more favourable (0–100 scale). All examinations were performed at baseline, 6 weeks, and 3, 6, 12, 18, 24, and 36 months. Results: Sixty patients (32 female, 28 male) were included (mean age: 71 ± 8.1 years). Visual acuity ranged from 20/80 to 20/20 at baseline. After 36 months, 34 patients remained in the study. The overall NEI–VFQ score fell from 76.8 at baseline to 59.8 in all patients. The scores in the most informative scales dropped from 52.1 to 22.1 (general health), 52.7 to 27.7 (general vision), 70.4 to 48.0 (near activity), and 84.8 to 66.0 (distance vision). The percentage of patients with VA >= 0.63 decreased from 21% at baseline to 3% three years later, while the group with VA <= 0.3 at baseline increased from 12% to 25% three years later. Conclusions:Patients with occult CNV experience a significant loss of vision over an observation period of three years. This is accompanied by a significant decline in quality of life as measured with the German version of the NEI–VFQ, which proved to be a reliable instrument for the measurement of HRQOL in ARMD.
Keywords: age–related macular degeneration • quality of life • clinical (human) or epidemiologic studies: natural history