Vision-Related Quality of Life among Patients with Different Types of Age-Related Macular Degeneration

Abstract

Background This study aimed to assess the vision-related quality of life (VRQol) of patients with age-related macular degeneration (AMD) and to evaluate VRQol according to different types of AMD.

Methods In this small-scale, single-center, prospective investigation, patients with AMD and subjects without any signs of macular disease were asked to complete the NEI-VFQ-39. A total of 159 subjects were included and grouped according to the type of AMD as follows: 40 patients with dry AMD in both eyes (DD), 40 patients with exudative AMD in one eye (DE), 41 patients with exudative AMD in both eyes (EE), and 38 subjects without any signs of macular disease, as a control group (CG).

Results The average age of the participants was 76 ± 7 years, and 44% were male. Most participants were retired (22.4%), and 75% of patients were initially diagnosed by their ophthalmologist. All the AMD groups had significantly worse overall VRQol than the CG. For general vision, near vision, mental health, and role difficulties, all the AMD groups had significantly lower scores than the CG. For distance vision, color vision, peripheral vision, driving difficulties, dependency, and social functioning, only patients in the EE and DE groups had significantly worse scores than the CG. The type of retinal fluid in patients with exudative AMD had no effect on overall VRQol; however, we found that the presence of pigment epithelial detachment could be associated with more role difficulties, such as completing work or working long hours.

Conclusion All types of AMD had a negative effect on vision-related quality of life. This effect was significantly more pronounced in patients with exudative AMD in at least one eye. However, the type of retinal fluid in patients with exudative AMD had no influence on their overall vision-related quality of life.

Zusammenfassung

Hintergrund Ziel dieser Studie war es, die visuelle Lebensqualität (VRQol) von Patienten mit altersbedingter Makuladegeneration (AMD) zu beurteilen und die VRQol nach verschiedenen AMD-Typen zu bewerten.

Methoden In dieser kleinen, prospektiven Studie wurden Patienten mit AMD und Probanden ohne Anzeichen einer Makulaerkrankung gebeten, den NEI-VFQ-39 auszufüllen. Insgesamt 159 Probanden wurden eingeschlossen und je nach nach der Art der AMD wie folgt eingeteilt: 40 Patienten mit trockener AMD in beiden Augen (DD), 40 Patienten mit exsudativer AMD in einem Auge (DE), 41 Patienten mit exsudativer AMD in beiden Augen (EE) und 38 Probanden ohne Anzeichen einer Makulaerkrankung als Kontrollgruppe (CG).

Ergebnisse Das Durchschnittsalter der Teilnehmer betrug 76 ± 7 Jahre und 44% waren männlich. Die meisten Teilnehmer waren im Ruhestand (22,4%), und bei 75% der Patienten wurde die Erstdiagnose von ihrem Augenarzt gestellt. Alle AMD-Gruppen hatten einen signifikant schlechteren Gesamt-VRQol als die CG-Gruppe. In den Bereichen allgemeines Sehen, Nahsehen, psychische Gesundheit und Rollenschwierigkeiten wiesen alle AMD-Gruppen signifikant niedrigere Werte auf als die CG-Gruppe. Für Fernsicht, Farbensehen, peripheres Sehen, Fahrschwierigkeiten, Abhängigkeit und soziales Funktionieren hatten nur die Patienten in den Gruppen EE und DE signifikant schlechtere Werte als die CG-Gruppe. Die Art der Netzhautflüssigkeit bei Patienten mit exsudativer AMD hatte keine Auswirkung auf den Gesamt-VRQol; wir fanden jedoch heraus, dass das Vorhandensein einer Pigmentepithelablösung mit mehr Schwierigkeiten bei der Ausübung von Tätigkeiten, wie z. B. dem Erledigen von Arbeiten oder langen Arbeitszeiten, verbunden sein könnte.

Schlussfolgerung Alle Arten von AMD hatten einen negativen Einfluss auf die visuelle Lebensqualität. Dieser Effekt war bei Patienten mit exsudativer AMD an mindestens einem Auge deutlich stärker ausgeprägt. Allerdings hatte die Art der Netzhautflüssigkeit bei Patienten mit exsudativer AMD keinen Einfluss auf die allgemeine visuelle Lebensqualität.

Conclusion Box

Already known:

• All types of AMD had a negative effect on vision-related quality of life.

• In the literature, the vision-related quality of life was not differentiated according to the type of AMD or type of retinal fluid.

Newly described:

• This negative effect was significantly more pronounced in patients with exudative AMD in at least one eye.

• The type of retinal fluid in patients with exudative AMD had no influence on their overall vision-related quality of life. However, the presence of pigment epithelial detachment could be associated with significantly more role difficulties.

Key words

NEI-VFQ-39 - retinal fluid - age-related macular degeneration - quality of life

Schlüsselwörter

NEI-VFQ-39 - altersbedingte Makuladegeneration - retinale Flüssigkeit - Lebensqualität

Publication History

Received: 05 June 2023

Accepted: 13 July 2023

Article published online:
06 September 2023

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