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Risk factors for poorer quality of life in patients with neovascular age-related macular degeneration: a longitudinal clinic-based study

Abstract

Background/Objectives

To examine the risk factors for poor vision-related and health-related quality of life (QoL) in patients with neovascular age-related macular degeneration (nAMD) who present for anti-vascular endothelial growth factor (anti-VEGF) therapy.

Methods

In a clinic-based cohort of 547 nAMD patients who presented for treatment, the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ25), Short-Form 36 (SF-36) and EuroQoL EQ-5D-5L questionnaires were administered to assess vision-related and health-related QoL. Of these, 83 participants were followed up one-year later to provide longitudinal data.

Results

Individuals with mild or moderate visual impairment or blindness at baseline had significantly lower NEI-VFQ-25 scores at follow-up. The presence of ≥3 chronic diseases was associated with lower SF-36 mental component scores (MCS) (p = 0.04) and EQ-VAS scores (p = 0.05). Depressive symptoms were associated with significantly lower MCS (p < 0.0001) and EQ-VAS scores (p = 0.02). Individuals with versus without impaired basic activities of daily living (ADLs) exhibited NEI-VFQ-25 and EQ-VAS scores that were 10.96 (p = 0.03) and 0.13 (p = 0.02) points lower. Those with impaired instrumental ADLs scored 11.62 (p = 0.02), 13.13 (p < 0.0001) and 15.8 (p = 0.0012) points lower in the NEI-VFQ-25, SF-36 physical component score and EQ-5D-5L summary score, respectively.

Conclusions

The QoL of nAMD patients is affected by visual acuity as well as patients’ medical history, mental health and functional status.

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Data availability

Data are available upon reasonable request. Deidentified participant data will be available upon request made to the corresponding author.

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Acknowledgements

We would like to acknowledge the Macular Disease Foundation Australia (MDFA) and The University of Sydney, Australia for their support of this study.

Funding

This study received funding from the Macular Disease Foundation Australia (MDFA).

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Contributions

Research design: KVV, PM, BG; Research execution: HD, KVV, PM; Data interpretation and analysis: KVV, BG, GB; Manuscript preparation: KVV, HD, GL, GB, PM, BG.

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Correspondence to Bamini Gopinath.

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Vu, K.V., Mitchell, P., Detaram, H.D. et al. Risk factors for poorer quality of life in patients with neovascular age-related macular degeneration: a longitudinal clinic-based study. Eye (2023). https://doi.org/10.1038/s41433-023-02407-0

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