Vision-related quality of life in patients with bilateral severe age-related macular degeneration

Abstract

Purpose: To determine the quality of life (QOL) of patients with bilateral severe age-related macular degeneration (AMD) before macular translocation with 360 degrees peripheral retinectomy.

Design: Prospective, consecutive, noncomparative case series.

Methods: An observational study assessed vision-related and general health QOL using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-item short form (SF-12) surveys, respectively. Mean QOL scores were correlated with patient age, duration of vision loss, and visual function. Mean QOL scores in study patients were compared with mean QOL scores in groups of patients with low vision, patients with AMD of varying severity, and reference populations.

Main outcome measures: National Eye Institute VFQ-25 and SF-12 QOL scores.

Results: Seventy patients with a mean age of 76.4 years were studied. Mean distance visual acuity (VA) was 62.4 (Early Treatment Diabetic Retinopathy Study letters), mean near VA was 0.81 (logarithm of the minimum angle of resolution), and mean reading speed was 74.9 words per minute. Important NEI VFQ-25 quality of vision subscales (general vision, difficulty with distance tasks, difficulty with near tasks) and vision-specific subscales (dependency, role difficulties, mental health, social function limitations) tended to correlate negatively with increasing patient age and duration of vision loss, but correlated positively with better VA and reading speed. The mean QOL scores for these important quality of vision and vision-specific subscales were significantly worse than or similar to mean scores in patients with low vision, and significantly worse than scores in patients with AMD of varying severity and a reference population. The mean SF-12 physical composite score in study patients was similar to that seen in patients with AMD of varying severity, but significantly higher than that in patients with low vision and a reference population. The SF-12 mental composite score in study patients was similar to those of all 3 comparison groups.

Conclusions: Patients with bilateral severe AMD have vision-related QOL similar to that of patients with low vision but significantly worse than those of patients with AMD of varying severity and persons without eye disease. This inability to perform vision-related daily tasks is not related to general health problems.