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Miin Roh, Alexandra Selivanova, Joan W Miller, Mary Lou Jackson; Factors influencing patient reported visual function in patients with bilateral age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2658.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate factors correlating to patient-reported visual function using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) in patients with bilateral advanced age-related macular degeneration(AMD).
Retrospective observational case series of 47 patients with advanced bilateral AMD. Age, gender, type of AMD, best-corrected visual acuity(VA), history of medical problems (stroke, cardiovascular disease, diabetes mellitus (DM), and malignancy), contrast sensitivity (CS),report of Charles Bonnet Syndrome(CBS) and current treatment for AMD were assessed. The extent of central field loss was assessed using monocular SLO-microperimetery (Optos plc, Dunfermline, Scotland) and a scoring system that considered the binocular summation of central field loss.
Mean age of patients was 83.2 years and NEI VFQ mean total score was 55.3. Multi-variable mixed linear regression model with other confounding factors showed that age (β=-0.287, 95 % CI; -0.040, -0.001, p=0.038), and presence of DM (β=-0.379, 95 % CI;, -0.475,-0.059, p=0.009) affected the general health score. VA (β=-0.456, 95 % CI; -0.460,-0.080, p=0.007), and history of cardiovascular disease (β=-0.284, 95 % CI; -0.553,-0.001, p=0.05) determined the general vision scores. History of DM was associated with increased report of ocular pain (β=-0.361, 95 % CI; -0.637,-0.031, p=0.016). CS affected scores on near activity (β= 0.579, 95% CI; 0.166, 0.604, p=0.001), mental health (β =0.360, 95% CI; 0.016,- 0.540, p=0.038), color vision (β =0.484, 95% CI; 0.073,0.498, p=0.010) and peripheral vision (β = 0.434, 95% CI;0.062, 0.439, p=0.011). Report of CBS predicts increased symptoms of mental health (β= -0.327, 95% CI;-0.934, -0.048, p=0.031) and limitation of peripheral vision (β= -0.356, 95% CI; -0.890, -0.051, p=0.029). Dependency subscale was affected by presence of DM (β= -0.458, 95% CI;-1.653, -0.373, p=0.003) and malignancy (β= -0.381, 95% CI;-1.256, -0.161, p=0.013).
Presence of DM affected various aspects of NEI VFQ-25 score. Binocular VA, CS, and report of CBS were factors predicting decreased visual fucntion, suggesting that these clinical factors should also be monitored to assess disease impact in patients who have low vision secondary to advanced AMD.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Color photograph( A), SLO-microperimetry(B), FA(C) and OCT(D) data of the right eye of a patient with bilateral AMD.
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