Back to Browse Journals » Clinical Ophthalmology » Volume 7

Assessing quality of life in the treatment of patients with age-related macular degeneration: clinical research findings and recommendations for clinical practice

Authors Yuzawa M, Fujita K, Tanaka E, Wang ECY

Published Date July 2013 Volume 2013:7 Pages 1325—1332

DOI http://dx.doi.org/10.2147/OPTH.S45248

Received 15 March 2013, Accepted 26 April 2013, Published 1 July 2013

Mitsuko Yuzawa,1 Kyoko Fujita,1 Erika Tanaka,2 Edward C Y Wang2

1Department of Ophthalmology, Nihon University School of Medicine, Surugadai, Kanda, Chiyoda-ku, Tokyo, Japan; 2Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Marunouchi, Chiyoda-ku, Tokyo, Japan

Background: The importance of incorporating quality-of-life (QoL) assessments into medical practice is growing as health care practice shifts from a “disease-based” to a “patient-centered” model. The prevalence of age-related macular degeneration (AMD) is increasing in today’s aging population. The purpose of this paper is: (1) to discuss, by reviewing the current literature, the impact of AMD on patients’ QoL and the utility of QoL assessments in evaluating the impact of AMD and its treatment; and (2) to make a recommendation for incorporating QoL into clinical practice.
Methods: We conducted a PubMed and an open Internet search to identify publications on the measurement of QoL in AMD, as well as the impact of AMD and the effect of treatment on QoL. A total of 28 articles were selected.
Results: AMD has been found to cause a severity-dependent decrement in QoL that is comparable to systemic diseases such as cancer, ischemic heart disease, and stroke. QoL impairment manifests as greater social dependence, difficulty with daily living, higher rates of clinical depression, increased risk of falls, premature admission to nursing homes, and suicide. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) is the most widely used eye disease-specific QoL instrument in AMD. It has been shown to correlate significantly with visual acuity (VA). QoL reflects aspects of AMD including psychological well-being, functional capacity, and the ability to perform patients’ valued activities, which are not captured by a single, numerical VA score.
Conclusion: The literature shows that the adverse impact of AMD on QoL is comparable to serious systemic disease. Eye disease-specific instruments for measuring QoL, such as the NEI VFQ-25, have shown a significant correlation of QoL decrement with measures of disease severity, as well as significant QoL improvement with treatment. The NEI VFQ-25 and other validated instruments provide a wide-ranging assessment of vision-related functioning that is important to patients and complementary to VA measurement. We strongly recommend the incorporation of QoL assessment into routine clinical practice.

Keywords: wet age-related macular degeneration, quality of life assessment, patient-reported outcome, clinical practice, review, NEI VFQ-25

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Non-Descemet’s stripping automated endothelial keratoplasty for bullous keratopathy secondary to iridoschisis

Minezaki T, Hattori T, Nakagawa H, Kumakura S, Goto H

Clinical Ophthalmology 2013, 7:1353-1355

Published Date: 3 July 2013

Choroidal neovascularization after blunt ocular trauma in angioid streaks

Kubota M, Hayashi T, Arai K, Tsuneoka H

Clinical Ophthalmology 2013, 7:1347-1351

Published Date: 3 July 2013

Macular dysfunction in drusen maculopathy assessed with multifocal electroretinogram and optical coherence tomography

Garcia-Garcia JG, Ruiz-Moreno JM, Holm K, Andreasson S, Lövestam-Adrian M

Clinical Ophthalmology 2013, 7:1303-1309

Published Date: 1 July 2013

Topical rebamipide improves the ocular surface in mild lagophthalmos

Itakura M, Itakura H, Kashima T, Akiyama H, Kishi S

Clinical Ophthalmology 2013, 7:1333-1338

Published Date: 1 July 2013

Postoperative subconjunctival bevacizumab injection as an adjunct to 5-fluorouracil in the management of scarring after trabeculectomy

Freiberg FJ, Matlach J, Grehn F, Karl S, Klink T

Clinical Ophthalmology 2013, 7:1211-1217

Published Date: 20 June 2013

Automated grading system for evaluation of ocular redness associated with dry eye

Rodriguez JD, Johnston PR, Ousler III GW, Smith LM, Abelson MB

Clinical Ophthalmology 2013, 7:1197-1204

Published Date: 20 June 2013

A comparison of two approaches to managing acute primary angle closure in Asian eyes

Ho H, Chew PT, Sng C, Huang H, Aung T, Perera SA

Clinical Ophthalmology 2013, 7:1205-1210

Published Date: 18 June 2013

Artifacts in diagnostic ultrasound

Hindi A, Peterson C, Barr RG

Reports in Medical Imaging 2013, 6:29-48

Published Date: 14 June 2013