Journal Article

Vision-related quality of life is selectively affected by comorbidities in patients with geographic atrophy

Sørensen, Torben Lykke, Holm, Ditte-Marie Leegaard, Nielsen, Marie Krogh, Højsted, Birte Bay

2023

Overview

Background The atrophic late stage of age-related macular degeneration (AMD) is termed geographic atrophy (GA), and affects visual acuity (VA) as well as quality of life (QoL). Previous studies have found that best-corrected VA (BCVA), the standard vision assessment often underrepresents functional deficits. Therefore, the purpose of this study was to evaluate the correlation between atrophic lesion size, VA and QoL measured with the National Eye Institute Visual Function Questionnaire (VFQ-39) in a Danish population. Moreover, we wanted to evaluate the correlation between comorbidities, behavioural factors, and QoL. Methods This was prospective clinical study of 51 patients with GA in one or both eyes, of these 45 patients had bilateral GA. Patients were consecutively included between April 2021 and February 2022. All patients filled in the VFQ-39 questionnaire except the subscales “ocular pain” and “peripheral vision.” Lesion size was measured from fundus autoflourescense images, and BCVA was assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Results We found an overall low score in each VFQ-39 subscale scores reflected by GA. Lesion size and VA were both significantly associated with all VFQ-39 subscale scores except for “general health.” VA showed a larger effect on QoL than lesion size. Chronic obstructive pulmonary disease (COPD) was associated with a lower score in the subscale score “general health” but none of the other subscale scores were affected. Cardiovascular disease (CVD) was associated with a lower BCVA as well as in QoL reflected in the subscale scores “poor general vision,” “near activities,” and “dependency” of VFQ-39. Conclusion Both atrophic lesion size and visual acuity affects QoL in Danish patients with GA, who reports an overall poor QoL. CVD seems to have a negative effect on disease, as well as in VFQ-39 in several subscales, whereas COPD did not affect disease severity or vision-related subscales in VFQ-39.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acuity / Age / Age-related macular degeneration / Atrophy / Cardiovascular diseases / Care and treatment / Chronic illnesses / Chronic obstructive pulmonary disease / Comorbidities / Comorbidity / Diabetes / Diabetes mellitus / Diabetic retinopathy / Early treatment diabetic retinopathy study / Fundus Oculi / Geographic Atrophy / Humans / Hypertension / Lesions / Lung diseases / Lung diseases, Obstructive / Macular degeneration / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Mental health / Obstructive lung disease / Ophthalmology / Patients / Prospective Studies / Pulmonary Disease, Chronic Obstructive / Quality of Life / Questionnaires / Retinopathy / Smoking / Tomography / Vision / Vision, Low / Vision-related quality of life / Visual acuity / Visual function questionnaire 39 / Visual perception