Abstract
Purpose
To assess visual function and its effects on vision-targeted, health-related quality of life (QOL) of patients with neovascular age-related macular degeneration (AMD) treated with photodynamic therapy (PDT) or full macular translocation (FMT).
Methods
Fifty patients with predominantly classic subfoveal choroidal neovascularisation (CNV) secondary to AMD were randomised to PDT or FMT. To test the vision-targeted QOL, the 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25 plus supplement) was administered prior to and 1 year after therapy. The change of vision-related QOL at 1 year in comparison to baseline was defined as primary end point.
Results
The vision-related subscales showed a stabilisation or even higher mean scores at 1 year in both treatment groups. A significant improvement in the quality of the subject’s vision-related subscales was only observed after FMT correlating with a more frequent increase in visual acuity. Comparing the results of the QOL scores after 1 year, the improvement of the subscale scores general vision (p = 0.03), mental health (p = 0.02) and dependency (p = 0.03) were significantly higher in the FMT arm.
Conclusions
FMT and PDT can achieve a stabilisation in vision-related QOL, in which FMT was superior to the PDT after 1 year. The discrepancy between the amount of patients with an increased visual acuity after FMT and a moderate improvement in QOL might be caused by the onset of complications related to this surgical procedure. Besides visual acuity, the impact of therapy-related complications has to be taken into consideration when evaluating new therapeutic concepts in exudative AMD.
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References
Klein R, Klein BE, Linton KL (1992) Prevalence of age-related maculopathy. The beaver dam eye study. Ophthalmology 99:933–943
Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report 1. Arch Ophthalmol 117:1329–1345
Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: two-year results of 2 randomized clinical trials—TAP report 2. Arch Ophthalmol 119:198–207
Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group (2002) Verteporfin therapy for subfoveal choroidal neovascularization in age-related macular degeneration: three-year results of an open-label extension of 2 randomized clinical trials—TAP report no. 5. Arch Ophthalmol 120:1307–1314
American Academy of Ophthalmology (2000) Macular translocation. Ophthalmology 107:1015–1018
Abdel-Meguid A, Lappas A, Hartmann K, Auer F, Schrage N, Thumann G, Kirchhof B (2003) One year follow up of macular translocation with 360 degree retinotomy in patients with age related macular degeneration. Br J Ophthalmol 87:615–621
Mruthyunjaya P, Stinnett SS, Toth CA (2004) Change in visual function after macular translocation with 360° retinectomy for neovascular age-related macular degeneration. Ophthalmology 111:1715–1724
Hewitt AW, Jeganathan SV, Kidd JE, Pesudovs K, Verma N (2006) Influence of photodynamic therapy for age related macular degeneration upon subjective vision related quality of life. Graefes Arch Clin Exp Ophthalmol 244(8):972–977
Armbrecht AM, Aspinall PA, Dhillon B (2004) A prospective study of visual function and quality of life following PDT in patients with wet age related macular degeneration. Br J Ophthalmol 88:1270–1273
Cahill MT, Stinnett SS, Banks AD, Freedman SF, Toth CA (2005) Quality of life after macular translocation with 360° peripheral retinectomy for age-related macular degeneration. Ophthalmology 112:144–151
Gelisken F, Voelker M, Schwabe R, Besch D, Aisenbrey S, Szurman P, Grisanti S, Herzau V, Bartz-Schmidt KU (2007) Full macular translocation versus photodynamic therapy with verteporfin in treatment of neovascular age-related macular degeneration: 1 year results of a prospective, controlled, randomised pilot- trial (FMT-PDT). Graefes Arch Clin Exp Ophthalmol [OnlineFirst 12 January 2007]
Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD, National Eye Visual Function Questionnaire Field Test Investigators (2001) Development of the 25-item national eye institute visual function questionnaire. Arch Ophthalmol 119:1050–1058
Stelmack JA, Stelmack TR, Massof RW (2002) Measuring low-vision rehabilitation outcomes with the NEI VFQ-25. Invest Ophthalmol Vis Sci 43:2859–2868
Clemons TE, Chew EY, Bressler SB, McBee W for the AREDS Research Group (2003) National eye institute visual function questionnaire in the age-related eye disease study (AREDS). Arch Ophthalmol 121:211–217
Mangione CM, Berry S, Spritzer K (1998) Identifying the content area for the 51-item national eye institute visual function questionnaire: results from focus groups with visually impaired persons. Arch Ophthalmol 116:227–233
Franke GH, Esser J, Voigtländer A, Mähner N (1998) Der National Eye Institute Visual Function Questionnaire (NEI-VFQ) — Erste Ergebnisse zur psychometrischen Überprüfung eines Verfahrens zur Erfassung der Lebensqualität bei Sehbeein- trächtigten. Z Med Psychol 7:178–184
Mangione CM (2000) The NEI VFQ-25 scoring algorithm. http://catalog.nei.nih.gov/productcart/pc/viewPrd.asp?idcategory=50&idproduct=60#). Cited 26 February 2007
Cahill MT, Banks AD, Stinnett SS, Toth CA (2005) Vision-related quality of life in patients with bilateral severe age-related macular degeneration. Ophthalmology 112(1):152–158
The Submacular Surgery Trials Research Group (2003) Responsiveness of the national eye institute visual function questionnaire to changes in visual acuity. Findings in patients with subfoveal choroidal neovascularization — SST report no. 1. Arch Ophthalmol 121:531–539
Michels S, Schmidt-Erfurth U, Rosenfeld PJ (2006) Promising new treatments for neovascular age-related macular degeneration. Expert Opin Investig Drugs 15(7):779–793
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Matthias Lüke and Focke Ziemssen contributed equally to the manuscript. The authors have no competing interests related to the manuscript.
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Lüke, M., Ziemssen, F., Bartz-Schmidt, K.U. et al. Quality of life in a prospective, randomised pilot-trial of photodynamic therapy versus full macular translocation in treatment of neovascular age-related macular degeneration — a report of 1 year results. Graefes Arch Clin Exp Ophthalmol 245, 1831–1836 (2007). https://doi.org/10.1007/s00417-007-0558-9
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DOI: https://doi.org/10.1007/s00417-007-0558-9