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The influence of the topographic location of geographic atrophy on vision-related quality of life in nonexudative age-related macular degeneration

  • Retinal Disorders
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Abstract

Purpose

To examine associations between the topographic distribution of geographic atrophy (GA) and vision-related quality of life (VRQoL).

Methods

This study included 237 eyes from 161 participants in the Age-Related Eye Disease Study (AREDS). GA lesions were manually delineated with color fundus photographs obtained by the AREDS Research Group and atrophic area was measured in an Early Treatment Diabetic Retinopathy Study (ETDRS) grid. VRQoL was measured using the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Area of atrophy in the ETDRS grid subfields was correlated with VRQoL by linear regression modeling.

Results

The average area of atrophy in the better and worse eye was 3.43mm2 and 7.15mm2 respectively. In multivariable analysis, VRQoL was not associated with total area of atrophy in the better eye (β, − 0.53; 95% confidence interval [CI], − 1.11 to 0.05; P = 0.07) or worse eye (β, 0.12; 95% CI, − 0.32 to 0.55; P = 0.59). However, area of atrophy in the central 1-mm-diameter zone of the better eye was significantly associated with VRQoL when the ETDRS subfields were examined individually (β, − 14.57; 95% CI, − 27.12 to − 2.02; P = 0.023), grouped into quadrants (β, − 18.35; 95% CI, − 30.03 to − 6.67; P = 0.002), inner and outer zones (β, − 17.26; 95% CI, − 29.38 to − 5.14; P = 0.006), or vertical and horizontal zones (β, − 18.97; 95% CI, − 30.18 to − 7.77; P = 0.001).

Conclusion

In patients with GA, greater area of atrophy in the central 1-mm-diameter zone of the better eye was independently associated with lower VRQoL, while total area of atrophy in the better or worse eye was not.

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Data availability

The Age-Related Eye Disease Study (AREDS) data are available upon request for authorized access: https://dbgap.ncbi.nlm.nih.gov/aa/wga.cgi?page=login.

Code availability

All study analyses were performed using R 3.6.0 (R Foundation for Statistical Computing, Vienna, Austria).

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Acknowledgements

The dataset used for the analyses described in this manuscript was obtained from the AREDS Database through dbGaP accession number phs000001.v3.p1. We would like to thank the AREDS participants and the AREDS Research Group for their valuable contribution to this research.

Funding

Research reported in this publication was supported by the Richard K. Gershon, MD, Student Research Fellowship (Recipient: AA), the National Institute on Aging of the National Institutes of Health under Award Number T35AG049685 (Recipient: AA), and P30 EY026878 from the National Eye Institute (NEI) (Recipient: Yale Vision Science Core). The sponsors or funding organizations had no role in the design or conduct of this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding support for AREDS was provided by the National Eye Institute (N01-EY-0–2127).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA

    Aneesha Ahluwalia

  2. Department of Ophthalmology, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Liangbo L. Shen

  3. Department of Statistics and Data Science, Yale University, New Haven, CT, USA

    Yihan Bao

  4. Institute of Cardiovascular Diseases, Gladstone Institute, San Francisco, CA, USA

    Mengyuan Sun

  5. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI, USA

    Benjamin K. Young

  6. Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA

    Michael M. Park

  7. Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, Suite 1B, New Haven, CT, USA

    Lucian V. Del Priore

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  1. Aneesha Ahluwalia
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Contributions

Conceptualization: Aneesha Ahluwalia, Liangbo L. Shen, Lucian V. Del Priore; methodology: Aneesha Ahluwalia, Liangbo L. Shen, Lucian V. Del Priore; formal analysis and investigation: Aneesha Ahluwalia, Yihan Bao; investigation: Aneesha Ahluwalia, Liangbo L. Shen, Mengyuan Sun, Benjamin K. Young, Michael M. Park; writing – original draft preparation: Aneesha Ahluwalia; writing – review and editing: Aneesha Ahluwalia, Liangbo L. Shen, Yihan Bao, Mengyuan Sun, Benjamin K. Young, Michael M. Park, Lucian V. Del Priore; supervision: Lucian V. Del Priore.

Corresponding author

Correspondence to Lucian V. Del Priore.

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This study was exempted by the Yale Institutional Review Board.

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Competing interests

L. V. Del Priore, Consultant—Astellas Institute for Regenerative Medicine, Boehringer Ingelheim; Scientific advisory board—Cavthe Rx, LambdaVision, Tissue Regeneration Sciences; Scientific advisor—Seeing Medicines; Research through university—Stealth Pharmaceuticals. The other authors declare no competing interests.

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Ahluwalia, A., Shen, L.L., Bao, Y. et al. The influence of the topographic location of geographic atrophy on vision-related quality of life in nonexudative age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 261, 699–708 (2023). https://doi.org/10.1007/s00417-022-05849-6

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