Risk factors for poorer quality of life in patients with neovascular age-related macular degeneration: a longitudinal clinic-based study

Background/Objectives To examine the risk factors for poor vision-related and health-related quality of life (QoL) in patients with neovascular age-related macular degeneration (nAMD) who present for anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods In a clinic-based cohort of 547 nAMD patients who presented for treatment, the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ25), Short-Form 36 (SF-36) and EuroQoL EQ-5D-5L questionnaires were administered to assess vision-related and health-related QoL. Of these, 83 participants were followed up one-year later to provide longitudinal data. Results Individuals with mild or moderate visual impairment or blindness at baseline had significantly lower NEI-VFQ-25 scores at follow-up. The presence of ≥3 chronic diseases was associated with lower SF-36 mental component scores (MCS) ( p = 0.04) and EQ-VAS scores ( p = 0.05). Depressive symptoms were associated with significantly lower MCS ( p < 0.0001) and EQ-VAS scores ( p = 0.02). Individuals with versus without impaired basic activities of daily living (ADLs) exhibited NEI-VFQ-25 and EQ-VAS scores that were 10.96 ( p = 0.03) and 0.13 ( p = 0.02) points lower. Those with impaired instrumental ADLs scored 11.62 ( p = 0.02), 13.13 ( p < 0.0001) and 15.8 ( p = 0.0012) points lower in the NEI-VFQ-25, SF-36 physical component score and EQ-5D-5L summary score, respectively. Conclusions The QoL of nAMD patients is affected by visual acuity as well as patients’ medical history, mental health and functional status.