Quality of life in patients with age–related macular degeneration: A prospective study

Abstract

Abstract: : Purpose: To assess self–reported visual functioning in a follow–up period of 12 months in patients with age–related macular degeneration (ARMD). Methods: Patients with all stages of ARMD were recruited for the prospective study. Examinations included ETDRS visual acuity, binocular ophthalmoscopy, color fundus photography, fluorescence angiography, and the German versions of the National Eye Institute Visual Functioning Questionnaire (NEI–VFQ). Scales on the NEI–VFQ range from 0 to 100, with higher scores more favourable. All examinations were performed at baseline, 3 months, 6 months, and 12 months intervals. Patients were subdivided according to their visual acuity into three groups: Group 1 had VA ≥20/32 in both eyes, Group 2 had one eye with VA of ≥20/32 and fellow eye with VA ≤ 20/63, and Group 3 had VA ≤ 20/63 in both eyes. Results: Two–hundred patients (131 female, 69 male; Group 1: n=38; Group 2: n=119; Group 3: n=43; age: 73±7.6 years) were included. Follow–up ranged from 3–12 months (mean: 10.6±3.7 months). Visual acuity (VA) ranged from hand motions up to 20/16 at baseline. The NEI–VFQ score (mean ± SD) of all patients at baseline were 72.7±16.5. At baseline NEI–VFQ scores were 83.1±7.1 for Group 1, 76.8±11.4 for Group 2, and 52.0±17.4 for Group 3. Patients with no loss of visual function during follow–up had stable, non–significant changes on the NEI–VFQ. During follow–up a total of 41 patients experienced a moderate loss of VA (≥3 ETDRS lines) and 23 patients experienced a severe visual loss (≥6 ETDRS lines). Of these 41 patients, 22 patients had visual loss in functional better eye, and the NEI–VFQ score dropped from 59.0 to 49.9 at 12 months. Conclusions: No loss of visual acuity are aligned with no changes in visual functioning, whereas a loss of visual acuity in the better functioning eye results in a significant loss in quality of life. The German version of the NEI–VFQ appears to be a valid for measurement of health–related quality of life in ARMD over time.

Keywords: age–related macular degeneration • low vision • aging