Factors affecting quality of life in patients with neovascular age-related macular degeneration

Purpose

This study examines how factors such as age, sex, best corrected visual acuity (BCVA), driving ability, and perceived treatment effectiveness influence quality of life (QoL) among patients with neovascular age-related macular degeneration (nAMD) in treatment with anti-vascular endothelial growth factor (VEGF) injections. Such information might be invaluable for healthcare providers, enabling them to understand who benefits from treatment.

Design

Survey-based cross-sectional study

Methods

We used questionnaire responses from patients receiving intravitreal anti-VEGF injections for nAMD to evaluate self-reported QoL, measured by the Macular Degeneration Quality of Life questionnaire. Background questions in the survey gathered patient information, while BCVA was obtained from medical records. The associations between self-rated QoL and various factors were analyzed using binomial logistic regression and linear regression. We calculated crude odds ratio (OR) and β-coefficient as well as OR and β-coefficient adjusted for sex, age, and BCVA.

Results

This study included 348 individuals, median age 79.2 years (IQR 75.0–84.0), with 58.3 % women. In the adjusted logistic model, factors associated with a QoL above average were male sex (OR 1.65, 95 % CI 1.04, 2.63), BCVA above 0.5 Snellen in best seeing eye (OR 11.16, 95 % CI 4.24, 29.35), preserved driving ability (OR 3.35, 95 % CI 1.80, 6.26), and perceiving treatment effectiveness (OR 2.15, 95 % CI 1.07, 4.34). The adjusted linear regression revealed the same associations, yet the positive relationship between QoL and biological sex was significant in the crude model but not in the adjusted model (β: 0.30, 95 % CI -0.04, 0.64).

Conclusion

Good visual acuity and driving ability strongly correlate with high QoL in patients with nAMD. Perceptions of the effectiveness of anti-VEGF treatment double the likelihood of high QoL, highlighting the need for further investigation into its potential clinical implications.