title: Verteporfin photodynamic therapy cohort study: report 2: clinical measures of vision and health-related quality of life.
abstract: OBJECTIVE
  To quantify decreases in health-related quality of life (HRQoL) for given deterioration in clinical measures of vision; to describe the shape of these relationships; and to test whether the gradients of these relationships change with duration of visual loss.
  
  
  METHODS
  A prospective, longitudinal study of patients treated with verteporfin photodynamic therapy in the United Kingdom National Health Service.
  
  
  METHODS
  Patients with neovascular age-related macular degeneration (AMD) treated in 18 ophthalmology departments in the United Kingdom with expertise in management of neovascular AMD.
  
  
  METHODS
  Responses to HRQoL questionnaires (Short Form 36 [SF-36] and National Eye Institute Visual Functioning Questionnaire [NEIVFQ]) and clinical measures of vision were recorded at baseline and at follow-up visits. Mixed regression models were used to characterize the relationships of interest.
  
  
  METHODS
  Measures of vision were best-corrected visual acuity (BCVA) and contrast sensitivity (CS). The SF-36 physical and mental component scores (PCS and MCS), SF-6D utility, and distance, near, and composite NEIVFQ scores were derived to characterize HRQoL.
  
  
  RESULTS
  The SF-6D, PCS, and MCS were linearly associated with BCVA; predicted decreases for a 5-letter drop in BCVA in the better-seeing eye were 0.0058, 0.245, and 0.546, respectively (all P<0.0001). Gradients were not influenced by duration of follow-up. Models predicting distance, near, and composite NEIVFQ scores from BCVA were quadratic; predicted decreases for a 5-letter drop in BCVA in the better-seeing eye were 5.08, 5.48, and 3.90, respectively (all P<0.0001). The BCVA predicted HRQoL scores more strongly than CS.
  
  
  CONCLUSIONS
  Clinically significant deterioration in clinical measures of vision is associated with small decreases in generic and vision-specific HRQoL. Our findings are important for further research modeling the cost effectiveness of current and future interventions for neovascular AMD.
authors: The London School of Hygiene and Tropical Medicine, London, England.
authors: Barnaby C
authors: BC
authors: Reeves
authors: Julia
authors: J
authors: Langham
authors: Jemma
authors: J
authors: Walker
authors: Richard
authors: R
authors: Grieve
authors: Usha
authors: U
authors: Chakravarthy
authors: Keith
authors: K
authors: Tomlin
authors: James
authors: J
authors: Carpenter
authors: Carla
authors: C
authors: Guerriero
authors: Simon P
authors: SP
authors: Harding
mesh_terms: D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D013222:State Medicine; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin