Abstract
Purpose :
It is known that clinical factors such as visual acuity do not fully predict vision-related quality of life (VrQoL). Therefore, recognizing patients in need of additional support, e.g. early referral to low vision services, may be challenging for ophthalmologists during busy consultation hours. The aim was to determine which demographic and clinical characteristics are predictive of VrQoL in patients receiving intravitreal anti-vascular endothelial growth factor (VEGF) treatment for macular edema due to exudative retinal diseases.
Methods :
Patients (n=712) were recruited from nine different locations of Bergman Clinics in The Netherlands. VrQoL was measured at baseline, 6 and 12 months using a newly developed itembank (EYE-Q) consisting of 47 items measuring VrQoL. The selected demographic characteristics potentially predictive of VrQoL were sex, age, civil status, education, employment status, and presence of non-ocular and ocular comorbidities. Selected clinical characteristics were visual acuity (VA), number of treated eyes, length of intravitreal anti-VEGF treatment, number of intravitreal anti-VEGF injections. Multivariate regression analysis was performed, using a forward selection procedure. The model was internal validated using the heuristic shrinkage factor.
Results :
The study population included 344 male participants (48.3%). Mean age was 76.2 years. The majority of participants were diagnosed with exudative age-related macular degeneration (63.3%) and 81.9% received one-sited treatment with anti-VEGF. Most participants (92.4%) had a VA of the better eye equal to or better than 0.5 LogMAR. Factors predictive of a lower VrQoL were a poorer LogMAR VA of the better eye (ß 0.97, 95% CI 0.378 to 1.17), female sex (ß 0.31, 95% CI 0.18 to 0.45), living alone (ß 0.24, 95% CI 0.09 to 0.39), older age (ß 0.01, 95% CI 0.00 to 0.02), a longer length of intravitreal anti-VEGF treatment at baseline (ß 0.06, 95% CI 0.01 to 0.11), and the presence of non-ocular and ocular comorbidities (ß 0.21, 95% CI 0.08 to 0.35 and ß 0.13, 95% CI 0.03 to 0.24). The heuristic shrinkage estimate was 0.96.
Conclusions :
Visual acuity appeared to be the strongest predictor of VrQoL in patients with macular edema receiving intravitreal anti-VEGF treatment, however other patient characteristics must also be considered for the risk assessment of low VrQoL and may be a reason for referral to low vision services.
This is a 2021 ARVO Annual Meeting abstract.