Health- and vision-related quality of life among patients with choroidal neovascularization secondary to age-related macular degeneration at enrollment in randomized trials of submacular surgery: SST report no. 4.
OBJECTIVE
To describe the effect of subfoveal choroidal neovascularization (CNV) from age-related macular degeneration (AMD) on health-related quality of life (HRQOL) of patients at enrollment in two randomized clinical trials; to examine the relation of visual acuity to HRQOL; to compare HRQOL scores between participants with unilateral and bilateral CNV independent of other characteristics.


METHODS
Randomized clinical trials.


METHODS
Two Submacular Surgery Trials (SST) recruited patients with AMD and either new subfoveal CNV (Group N Trial) or predominantly hemorrhagic CNV (Group B Trial). Health-related quality of life interviews included the National Eye Institute Visual Function Questionnaire [NEI-VFQ], the SF-36 Health Survey, and the Hospital Anxiety and Depression Scale [HADS]. Linear correlation and regression analyses were used to relate baseline HRQOL scores to visual acuity and bilateral disease.


RESULTS
Interview data were analyzed for 789 AMD patients: 454 patients in the Group N Trial and 335 patients in the Group B Trial. Participants reported poor vision-related functioning in many domains measured by the NEI-VFQ (mean overall scores of 65 for Group N and 63 for Group B). Visual acuity of the better eye was strongly associated with NEI-VFQ scores but not with SF-36 or HADS scores. After adjusting for visual acuity of the better eye and other factors, bilateral cases had NEI-VFQ overall scores six points lower than unilateral cases in Group N Trial and 10 points lower than unilateral cases in the Group B Trial.


CONCLUSIONS
Subfoveal CNV profoundly affects vision-related quality of life. The effect is more pronounced with bilateral disease, even after controlling for visual acuity.
Dong
Li Ming
LM
Wilmer Clinical Trials and Biometry, The Wilmer Ophthalmologic Institute, 550 N. Broadway, 9th Floor, Baltimore, MD 21205-2010, USA.
Childs
Ashley L
AL
Mangione
Carol M
CM
Bass
Eric B
EB
Bressler
Neil M
NM
Hawkins
Barbara S
BS
Marsh
Marta J
MJ
Miskala
Päivi
P
Jaffee
Harrris A
HA
McCaffrey
Lee A
LA
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000209:etiology / Q000523:psychology*; D005260:Female; D005451:Fluorescein Angiography; D006304:Health Status; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States; D014792:Visual Acuity / Q000502:physiology*