What are the most common symptoms reported by patients presenting with neovascular age-related macular degeneration? A bicentre study

Abstract

Purpose : Neovascular age-related macular degeneration (nAMD) is a degenerative retinal disease that when untreated leads to severe visual loss. Prompt detection of the disease may achieve better therapeutic outcomes. This study aimed to ascertain the presenting symptoms of nAMD in 2 different population groups and examined how awareness interacts with clinical variables.

Methods : In this bicentre, cross-sectional study conducted from September to December 2021 in Milan and Dublin, patients with nAMD attending the intravitreal injection service were included. Four age-subgroups were considered: 60-69, 70-79, 80-89, >90. The patients completed an interviewer-administered questionnaire regarding their symptoms at the time of nAMD onset. Individuals were divided into group A composed of Italian patients and group B consisted of Irish patients. The 2 groups were compared using the Chi-square test with Yates correction for categorical variables (univariate analyses). P-values <.05 were considered statistically significant.

Results : 152 patients with nAMD were included in the study, 56 in group A and 96 in group B.
The most common age-subgroup was 80-89 years (46.7%); 95(62.5%) patients were females, while 57(37.5%) were males. The most frequent symptom at presentation was difficulty when reading (n=57,37.5%), followed by both drop in central vision in one eye (n=52,34.2%) and distortion (n=52,34.2%). Other presenting symptoms were a transient shadow upon wakening (n=26,17.1%), difficulty in going from light to dark (n=9,5.9%), and also in recognizing faces (n=6,3.9%). Notably, 44 patients (28.9%) were asymptomatic. Univariate linear regression analyses didn't reveal a significant association of awareness of the disease with age and sex. Interestingly, group A was more likely to be aware of the disease onset compared to group B X² (1,N=152)=4.483, p=.0342.

Conclusions : These findings show that almost a third of patients with nAMD are asymptomatic at the time of their first presentation. Symptom awareness was higher among the Italian cohort compared to the Irish group. nAMD patients should attend regular ophthalmic/optical coherence tomography monitoring rather than rely on subjective symptoms.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Figure 1. Histograms represent the differences between group A (dark grey bars), and group B (light grey bars). Asterisk shows a statistically significant difference (p<.05).