Tracing the natural course of visual acuity and quality of life in neovascular age-related macular degeneration: A systematic review and quality of life study

Mari Elshout, Carroll A. Webers, Margriet I. Van Der Reis, Yvonne De Jong-Hesse, Jan S. Schouten

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Background: Describing the natural course of neovascular age-related macular degeneration (nAMD) is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies. Methods: First, we performed a literature search in PubMed, Embase, and Cochrane. We included randomized clinical trials and prospective observational studies reporting visual acuity (VA) in non-treated patients, 24 studies in total. We integrated VA data using best fit on Lineweaver-Burke plots and modelled with non-linear regression using reciprocal terms. Second, we performed a quality-of-life (QoL) study in nAMD patients. We measured VA with Radner reading charts and QoL with the Health Utilities Index issue 3 (HUI-3) questionnaire in 184 participants. We studied the relation VA-QoL with linear regression. Third, with Monte Carlo simulation, we integrated the VA model from the literature review and the relation VA-QoL from the QoL study. Results: Visual acuity was 0.4 and 0.07 after 5 years in the better-seeing, and worse-seeing eye, respectively. After 4.3 years, VA was <0.5 in the better-seeing eye; <0.3 after 7 years; 0.05 after 17 years. QoL score decreased from 0.6 to 0.45 after 10 years. Conclusions: The natural course of nAMD in both eyes needs to be considered when informing patients. Visual acuity in the best eye decreases to below 0.5 in 4.3 years. This affects QoL significantly.

Original languageEnglish
Article number120
JournalBMC Ophthalmology
Volume17
Issue number1
DOIs
Publication statusPublished - 11 Jul 2017

Cite this

@article{c6de9ac702754763808755f655f54c53,
title = "Tracing the natural course of visual acuity and quality of life in neovascular age-related macular degeneration: A systematic review and quality of life study",
abstract = "Background: Describing the natural course of neovascular age-related macular degeneration (nAMD) is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies. Methods: First, we performed a literature search in PubMed, Embase, and Cochrane. We included randomized clinical trials and prospective observational studies reporting visual acuity (VA) in non-treated patients, 24 studies in total. We integrated VA data using best fit on Lineweaver-Burke plots and modelled with non-linear regression using reciprocal terms. Second, we performed a quality-of-life (QoL) study in nAMD patients. We measured VA with Radner reading charts and QoL with the Health Utilities Index issue 3 (HUI-3) questionnaire in 184 participants. We studied the relation VA-QoL with linear regression. Third, with Monte Carlo simulation, we integrated the VA model from the literature review and the relation VA-QoL from the QoL study. Results: Visual acuity was 0.4 and 0.07 after 5 years in the better-seeing, and worse-seeing eye, respectively. After 4.3 years, VA was <0.5 in the better-seeing eye; <0.3 after 7 years; 0.05 after 17 years. QoL score decreased from 0.6 to 0.45 after 10 years. Conclusions: The natural course of nAMD in both eyes needs to be considered when informing patients. Visual acuity in the best eye decreases to below 0.5 in 4.3 years. This affects QoL significantly.",
keywords = "Age-related macular degeneration, Cost-effectiveness, Natural progression, Prognosis, Quality of life, Visual acuity",
author = "Mari Elshout and Webers, {Carroll A.} and {Van Der Reis}, {Margriet I.} and {De Jong-Hesse}, Yvonne and Schouten, {Jan S.}",
year = "2017",
month = "7",
day = "11",
doi = "10.1186/s12886-017-0514-3",
language = "English",
volume = "17",
journal = "BMC Ophtalmology",
issn = "1471-2415",
publisher = "BioMed Central",
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Tracing the natural course of visual acuity and quality of life in neovascular age-related macular degeneration : A systematic review and quality of life study. / Elshout, Mari; Webers, Carroll A.; Van Der Reis, Margriet I.; De Jong-Hesse, Yvonne; Schouten, Jan S.

In: BMC Ophthalmology, Vol. 17, No. 1, 120, 11.07.2017.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Tracing the natural course of visual acuity and quality of life in neovascular age-related macular degeneration

T2 - A systematic review and quality of life study

AU - Elshout, Mari

AU - Webers, Carroll A.

AU - Van Der Reis, Margriet I.

AU - De Jong-Hesse, Yvonne

AU - Schouten, Jan S.

PY - 2017/7/11

Y1 - 2017/7/11

N2 - Background: Describing the natural course of neovascular age-related macular degeneration (nAMD) is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies. Methods: First, we performed a literature search in PubMed, Embase, and Cochrane. We included randomized clinical trials and prospective observational studies reporting visual acuity (VA) in non-treated patients, 24 studies in total. We integrated VA data using best fit on Lineweaver-Burke plots and modelled with non-linear regression using reciprocal terms. Second, we performed a quality-of-life (QoL) study in nAMD patients. We measured VA with Radner reading charts and QoL with the Health Utilities Index issue 3 (HUI-3) questionnaire in 184 participants. We studied the relation VA-QoL with linear regression. Third, with Monte Carlo simulation, we integrated the VA model from the literature review and the relation VA-QoL from the QoL study. Results: Visual acuity was 0.4 and 0.07 after 5 years in the better-seeing, and worse-seeing eye, respectively. After 4.3 years, VA was <0.5 in the better-seeing eye; <0.3 after 7 years; 0.05 after 17 years. QoL score decreased from 0.6 to 0.45 after 10 years. Conclusions: The natural course of nAMD in both eyes needs to be considered when informing patients. Visual acuity in the best eye decreases to below 0.5 in 4.3 years. This affects QoL significantly.

AB - Background: Describing the natural course of neovascular age-related macular degeneration (nAMD) is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies. Methods: First, we performed a literature search in PubMed, Embase, and Cochrane. We included randomized clinical trials and prospective observational studies reporting visual acuity (VA) in non-treated patients, 24 studies in total. We integrated VA data using best fit on Lineweaver-Burke plots and modelled with non-linear regression using reciprocal terms. Second, we performed a quality-of-life (QoL) study in nAMD patients. We measured VA with Radner reading charts and QoL with the Health Utilities Index issue 3 (HUI-3) questionnaire in 184 participants. We studied the relation VA-QoL with linear regression. Third, with Monte Carlo simulation, we integrated the VA model from the literature review and the relation VA-QoL from the QoL study. Results: Visual acuity was 0.4 and 0.07 after 5 years in the better-seeing, and worse-seeing eye, respectively. After 4.3 years, VA was <0.5 in the better-seeing eye; <0.3 after 7 years; 0.05 after 17 years. QoL score decreased from 0.6 to 0.45 after 10 years. Conclusions: The natural course of nAMD in both eyes needs to be considered when informing patients. Visual acuity in the best eye decreases to below 0.5 in 4.3 years. This affects QoL significantly.

KW - Age-related macular degeneration

KW - Cost-effectiveness

KW - Natural progression

KW - Prognosis

KW - Quality of life

KW - Visual acuity

UR - http://www.scopus.com/inward/record.url?scp=85022068602&partnerID=8YFLogxK

U2 - 10.1186/s12886-017-0514-3

DO - 10.1186/s12886-017-0514-3

M3 - Review article

VL - 17

JO - BMC Ophtalmology

JF - BMC Ophtalmology

SN - 1471-2415

IS - 1

M1 - 120

ER -