title: Influence of age-related maculopathy on visual functioning and health-related quality of life.
abstract: OBJECTIVE
  To describe the influence of age-related maculopathy on visual functioning and health-related quality of life.
  
  
  METHODS
  A prospective, cross-sectional, observational cohort sample of 201 persons with various stages of age-related maculopathy was recruited from the Massachusetts Eye and Ear Infirmary as part of a longitudinal study of age-related macular degeneration. Persons were considered to have age-related maculopathy if one or more of the following clinical characteristics were present: drusen, retinal pigment epithelial changes, geographic atrophy, or evidence of exudative disease. Median corrected visual acuity for this sample was 20/25 in the better eye, with all subjects having 20/200 or better visual acuity in at least one eye at baseline. All participants underwent a comprehensive ophthalmologic examination with a dilated pupil. In addition to the usual clinical data collection, severity of age-related maculopathy was graded by an ophthalmologist who used standard clinical criteria and was masked to the participants' descriptions of visual functioning and health-related quality of life. All participants completed an interview that included the Activities of Daily Vision Scale, a survey designed to assess difficulties with routine daily activities that require vision, and the Short Form-36 Health Survey, a generic measure of multidimensional health-related quality of life.
  
  
  RESULTS
  Severity of age-related maculopathy was associated with poorer scores of the Activities of Daily Vision Scale. This association was most significant for near vision and driving activities. In this sample, the SF-36 Health Survey scales were not significantly correlated with severity of age-related maculopathy.
  
  
  CONCLUSIONS
  Reported visual functioning is significantly associated with the clinical severity of age-related maculopathy. However, once visual acuity is taken into consideration, clinical grading of age-related maculopathy did not explain a significant portion of the variation in visual functioning. The lack of significant correlation between severity of age-related maculopathy and the SF-36 Health Survey may have resulted from the small number of participants in our sample with severe bilateral age-related maculopathy.
authors.affiliation: Department of Medicine, UCLA School of Medicine, Los Angeles, California 90024-8012, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Mangione
authors.forename: P R
authors.initials: PR
authors.lastname: Gutierrez
authors.forename: G
authors.initials: G
authors.lastname: Lowe
authors.forename: E J
authors.initials: EJ
authors.lastname: Orav
authors.forename: J M
authors.initials: JM
authors.lastname: Seddon
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008268:Macular Degeneration / Q000145:classification / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D014792:Visual Acuity / Q000502:physiology*