Abstract
Purpose :
To assess the impact of longitudinal changes in age-related macular degeneration (AMD) on health related quality of life in Latinos.
Methods :
The LALES was a population-based cohort study of ocular disease and quality of life (QoL) in Latinos, aged 40 years and older. At baseline and 4 year follow-up participants underwent detalied ophthalmic examination, stereoscopic fundus photography and assessment of QoL. A modification of the Wisconsin Age-Related Maculopathy Grading System (WARMGS) was used to grade AMD lesions and assess progression. General QoL was assessed by the Short Form 12-item Health Survey (SF-12) and vision-related QoL was assessed by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Intra-individual change in QoL scores were calculated by subtracting scores at baseline from scores at 4-year follow-up. Analysis of covariance was used to model mean differences of change in QoL scores across severity levels of AMD. To quantify the significance of intra-individual changes, minimally important change (MIC) in QoL across severity levels of AMD was assessed and tested.
Results :
In baseline and follow-up, 3,001 participants had gradable fundus photograph and complete QoL data and were included in this analysis. Even through early stages of progression, there was evidence of diminishing QoL. In people without co-existing ocular conditions, there were statistically significant decrease in several QoL subscale scores with worsening of AMD, including vision-related dependency (P=0.001), driving difficulty (P=0.03), distant vision (P=0.02), general vision (P=0.01) and vision related social function (P=0.04). Significantly larger proportion of people with progression of AMD had a MIC in these QoL subscales suggesting measurable intra-individual impact of AMD worsening on QoL.
Conclusions :
In this cohort of Latinos, people with clinically meaningful progression of AMD have diminished health-related quality of life, even in progression through early stages of AMD. The impact of AMD worsening was significant on average QoL scores and on measures at the individual level. These results suggest that interventions aimed at worsening AMD at any stage might have beneficial impact on visual functioning of patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.