Vision-related quality of life in patients with bilateral severe age-related macular degeneration.

PURPOSE: To determine the quality of life (QOL) of patients with bilateral severe age-related macular degeneration (AMD) before macular translocation with 360 degrees peripheral retinectomy. DESIGN: Prospective, consecutive, noncomparative case series. METHODS: An observational study assessed vision-related and general health QOL using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-item short form (SF-12) surveys, respectively. Mean QOL scores were correlated with patient age, duration of vision loss, and visual function. Mean QOL scores in study patients were compared with mean QOL scores in groups of patients with low vision, patients with AMD of varying severity, and reference populations. MAIN OUTCOME MEASURES: National Eye Institute VFQ-25 and SF-12 QOL scores. RESULTS: Seventy patients with a mean age of 76.4 years were studied. Mean distance visual acuity (VA) was 62.4 (Early Treatment Diabetic Retinopathy Study letters), mean near VA was 0.81 (logarithm of the minimum angle of resolution), and mean reading speed was 74.9 words per minute. Important NEI VFQ-25 quality of vision subscales (general vision, difficulty with distance tasks, difficulty with near tasks) and vision-specific subscales (dependency, role difficulties, mental health, social function limitations) tended to correlate negatively with increasing patient age and duration of vision loss, but correlated positively with better VA and reading speed. The mean QOL scores for these important quality of vision and vision-specific subscales were significantly worse than or similar to mean scores in patients with low vision, and significantly worse than scores in patients with AMD of varying severity and a reference population. The mean SF-12 physical composite score in study patients was similar to that seen in patients with AMD of varying severity, but significantly higher than that in patients with low vision and a reference population. The SF-12 mental composite score in study patients was similar to those of all 3 comparison groups. CONCLUSIONS: Patients with bilateral severe AMD have vision-related QOL similar to that of patients with low vision but significantly worse than those of patients with AMD of varying severity and persons without eye disease. This inability to perform vision-related daily tasks is not related to general health problems.

Quality of life after macular translocation with 360 degrees peripheral retinectomy for age-related macular degeneration.

PURPOSE: To determine patients' quality of life (QOL) after macular translocation with 360 degrees peripheral retinectomy (MT360) for age-related macular degeneration. DESIGN: Prospective, interventional, consecutive, noncomparative case series. METHODS: A prospective study assessed QOL 1 year after MT360 and its relation to postoperative visual function. The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-item short form (SF-12) health survey were used to assess vision-related QOL and general health, respectively. Surveys were administered preoperatively and postoperatively. Postoperative NEI VFQ-25 QOL and SF-12 subscale scores for all patients were compared with the preoperative scores. Preoperative and postoperative distance and near visual acuities (VAs) and reading speed were assessed. Changes in NEI VFQ-25 QOL subscale scores were compared in patients with and without improved visual function. Postoperative NEI VFQ-25 QOL subscale scores in patients with distance VA of >or=69 Early Treatment Diabetic Retinopathy Study letters, near VA of >or=20/70, and reading speed of >or=90 words per minute were compared with subscale scores in patients with worse postoperative visual function. MAIN OUTCOME MEASURES: National Eye Institute VFQ-25 and SF-12 QOL scores and their association with distance VA, near VA, and reading speed. RESULTS: In total, 50 patients with a mean age of 76.9 years were studied. Postoperative mean NEI VFQ-25 QOL scores were higher than the preoperative mean scores, and this difference was significant for important vision-specific subscales. Patients with improved visual function had greater mean changes in NEI VFQ-25 QOL scores than those with no improvement. Patients with the outlined higher levels of visual function had greater mean NEI VFQ-25 QOL scores than those who had worse visual function. Preoperative and postoperative mean SF-12 QOL scores were similar. CONCLUSIONS: Macular translocation with 360 degrees peripheral retinectomy was associated with improvement in vision-related QOL. The amount of improvement was greatest in patients with postoperative improvement in visual function, and the best postoperative vision-related QOL was seen in patients with better postoperative visual function. This was not associated with a change in patients' general health.

Improvement in near visual function after macular translocation surgery with 360-degree peripheral retinectomy.

BACKGROUND: Information is limited on how specific near-vision skills are impacted by therapies such as macular translocation surgery with 360-degree retinectomy (MT360) for age-related macular degeneration (AMD). METHODS: Standardized tests of near vision were given to 25 consecutive patients with AMD who met entry criteria for this study, preoperatively and 6 and 12 months after MT360. Tests included: near acuity with the Lighthouse chart, timed reading speed using Sloan cards, contrast sensitivity, and color vision. Distance acuity was measured using Bailey-Lovey charts. Measures of preoperative visual function were analyzed to identify those predictive of visual outcomes. RESULTS: Distance acuity was 20/80 or better in 52% of patients at 12 months after surgery, and mean acuity improved from approximately 20/125 preoperatively to approximately 20/100 at 12 months. Mean near acuity improved from 3.2+/-2.5 M before surgery to 1.5+/-1.0 M at 12 months (significant change of -1.5+/-2 M, P<0.001). Gain of greater than five numbers in contrast sensitivity at 12 months was also significant ( P<0.001). Mean reading speed improved from 41+/-31 words per minute (wpm) before surgery to 67+/-44 wpm at 12 months (significant gain of 25+/-33 wpm, P=0.001). Preoperative distance acuity, near acuity, and reading speed were each predictors of postoperative near visual function. CONCLUSION: Standardized testing of near visual function provides important predictive and functional outcome data for MT360. MT360 significantly improved near visual function (including near acuity, reading speed and contrast sensitivity) in patients with subfoveal lesions from AMD in the second eye.