Abstract
Purpose :
Retinal diseases such as neovascular age related macular degeneration (nAMD), diabetic macular edema (DME) or branch-/central retinal vein occlusion (B/CRVO) may affect the patients’ quality of life (QoL). Our study investigates how patients QoL changes during the first year of anti-vascular endothelial growth factor (anti-VEGF) treatment. Possible factors influencing the QoL impact on the patient perspective were analysed.
Methods :
The ALBATROS data collection was set up to assess the care situation of patients in Germany for patients undergoing intravitreal treatment with any approved anti-VEGF drug. Treatment-naïve patients were enrolled diagnosed with either nAMD, DME or B/CRVO. The data collection was scheduled for twelve months with a screening and baseline assessment in the beginning and a follow-up visit twelve months later. Apart from various clinical parameters, we assessed QoL with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the generic Short-Form (SF)-36 as well as with additional exploratory questions about the patients’ psychological situation, including in particular their perception of fear of vision loss. Data were analyzed as observed. NEI-VFQ-25 composite and subscale scores along with Rasch-transformed scales were calculated. Results were stratified by indication.
Results :
102 study sites across Germany were included. Data were collected from 1444 nAMD (mean 78 years), 445 DME (66 y), 233 BRVO (69 y) and 144 CRVO (70 y) patients. Both the generic (SF36) as well as the eye-specific QOL-instrument (NEI-VFQ 25) showed that reduced general health had the greatest impact on QoL, while emotional and social factors still had a significant impact. The majoritiy of patients reported anxiety about visual impairment and blindness at baseline (77% nAMD, 71% DME, 61% BRVO, 71% CRVO). Overall, the emotional impact of retinal disease was more stressful for patients than the treatment itself. During the course of treatment, the QoL remained stable and the sense of anxiety even improved.
Conclusions :
Retinal disease and anti-VEGF-treatment is a major burden for patients. However, even with low general health perception and widespread fear of vision loss, QoL and psychological parameters were maintained and sometimes even improved during the first year of anti-VEGF-treatment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.