Health-related Quality of Life Measured by the NEI-VFQ in 300 Patients with Age-related Macular Degeneration

Abstract

Abstract: : Purpose: Quality of life analysis offers a method of incorporating clinical outcomes measurement into patient care, quality management and clinical studies. Here we evaluate the German Version of the National Eye Institute Visual Function Questionnaire (NEI-VFQ) cross-sectionally in patients with age related macular degeneration (ARMD). Method:ARMD patients presented with all stages of ARMD including drusen in both eyes (n=38), CNV in one eye (n=187) and CNV or scar in both eyes (n=76). Examinations included in all cases ETDRS acuity, ophthalmoscopy, fundus photography and fluorescein and ICG angiography in selected cases and the German versions of the SF-36 and NEI-VFQ. The NEIVFQ has 12 subscales: General health and General Vision (GV), Pain (P), Near-(NV), Peripheral-, Colour and Distance vision (DV), Driving (D), Vision specific: Role difficulties, Dependency, Social function (SF), Mental health (MH). Scores are based on a 10to 100 scale; higher scores are more favourable.Results:301 (187 female, 114 male) were included into the study. Mean age was 72. Overall NEIVFQ score was 73.7 compared with 88.4 in the control group (360 subjects). Patients with VA >= 0.63 in both eyes scored 83, those with VA £ 0.32 in one eye and VA >= 0.63 in the partner eye scored 76 and patients with VA £ 0.32 in both eyes scored 49 over all. The scales for GV (55.3); NV (69), SF (75), MH (67) and D (62) appeared to be most sensitive. When both eyes had late stage disease with VA £ 0.32 scores dropped very significantly (P<0.05) in all scales except ocular pain. Conclusion:The German version of the NEIVFQ appears to be a reliable instrument for the measurement of HRQOL in ARMD. If one eye is affected by ARMD, the fellow eye can compensate somewhat, although patients are severely affected in their social functioning and mental health. Advanced stages and progression of the disease can result in substantial loss of HRQOL.

Keywords: age-related macular degeneration • quality of life • clinical (human) or epidemiologic studies: out