Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study

ABSTRACT BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.

Quality of life in patients with age-related macular degeneration with monocular and binocular legal blindness

OBJECTIVE: To evaluate the quality of life for persons affected by age-related macular degeneration that results in monocular or binocular legal blindness. METHODS: An analytic transversal study using the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was performed. Inclusion criteria were persons of both genders, aged more than 50 years old, absence of cataracts, diagnosis of age-related monocular degeneration in at least one eye and the absence of other macular diseases. The control group was paired by sex, age and no ocular disease. RESULTS: Group 1 (monocular legal blindness) was composed of 54 patients (72.22 percent females and 27.78 percent males, aged 51 to 87 years old, medium age 74.61 ± 7.27 years); group 2 (binocular legal blindness ) was composed of 54 patients (46.30 percent females and 53.70 percent males aged 54 to 87 years old, medium age 75.61 ± 6.34 years). The control group was composed of 40 patients (40 percent females and 60 percent males, aged 50 to 81 years old, medium age 65.65 ± 7.56 years). The majority of the scores were statistically significantly higher in group 1 and the control group in relation to group 2 and higher in the control group when compared to group 1. CONCLUSIONS: It was evident that the quality of life of persons with binocular blindness was more limited in relation to persons with monocular blindness. Both groups showed significant impairment in quality of life when compared to normal persons.

OBJETIVO: Avaliar a qualidade de vida de portadores de degeneração macular relacionada à idade com cegueira legal monocular e binocular. MÉTODOS: Foi realizado estudo transversal analítico por meio do questionário National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25). Os critérios de inclusão foram: indivíduos de ambos os sexos, idade maior que 50 anos, ausência de catarata, diagnóstico de degeneração macular relacionada à idade avançada em pelo menos um dos olhos, sem outras maculopatias. O Grupo Controle foi pareado por sexo, idade e sem doença ocular. RESULTADOS: O Grupo 1 (cegueira monocular) foi composto por 54 pacientes (72,22 por cento de mulheres e 27,78 por cento de homens, idade entre 51 e 87 anos, média de 74,61 anos ± 7,27 anos); o Grupo 2 (cegueira binocular), por 54 (46,30 por cento de mulheres e 53,70 por cento de homens, idade entre 54 e 87 anos, média de 75,61 anos ± 6,34 anos). O Grupo Controle foi composto por 40 pacientes (40 por cento de mulheres e 60 por cento de homens, idade entre 50 e 81 anos, média de 65,65 anos ± 7,56 anos). A maioria dos escores foi significativamente maior no Grupo 1 e no Controle em relação ao Grupo 2 e maior no Controle comparado ao Grupo 1. CONCLUSÕES: Evidenciou-se que a qualidade de vida de indivíduos com cegueira binocular foi mais limitada em relação aos portadores de cegueira monocular. Quando comparados com indivíduos normais, ambos os grupos tiveram prejuízo na qualidade de vida foi significativo.