Brown Melissa M, Brown Gary C, Stein Joshua D, Roth Zachary, Campanella Joseph, Beauchamp George R
Center for Value-Based Medicine, Flourtown 19031, and the Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, USA.
Can J Ophthalmol. 2005 Jun;40(3):277-87. doi: 10.1016/S0008-4182(05)80070-5.
It can be estimated that 17,100 new cases of neovascular (wet) AMD and 180,000 new cases of geographic-atrophy (dry) AMD occur in Canada annually. In addition to having a devastating effect on patients' lives, the condition causes significant adverse consequences for the economy. The deleterious effect of AMD on quality of life is markedly underestimated by ophthalmologists who treat patients with AMD, by non-ophthalmic physicians and by the public. In fact, patients with different degrees of severity of AMD have a perceived impairment of their quality of life that is 96% to 750% greater than the impairment estimated by treating ophthalmologists. Mild AMD causes a 17% decrease in the quality of life of the average patient, a decrease similar to that encountered with symptomatic human immunodeficiency virus infection or moderate cardiac angina. Moderate AMD produces a 40% decrease in quality of life, a decrease similar to that associated with permanent renal dialysis or severe cardiac angina. Very severe AMD causes a 63% decrement in quality of life, a decrease similar to that encountered with advanced prostatic cancer with uncontrollable pain or a severe stroke that leaves a person bedridden, incontinent and requiring constant nursing care. The adverse economic consequences of AMD include an annual $2.6 billion negative impact on Canada's gross domestic product. The return on investment is high for both current AMD therapies and research into new treatment modalities.
据估计，加拿大每年有17100例新生血管性（湿性）年龄相关性黄斑变性（AMD）病例和180000例地图状萎缩性（干性）AMD病例。除了对患者的生活造成毁灭性影响外，这种疾病还会给经济带来重大不利后果。AMD对生活质量的有害影响被治疗AMD患者的眼科医生、非眼科医生和公众严重低估。事实上，不同严重程度的AMD患者所感受到的生活质量受损程度比治疗眼科医生估计的受损程度高96%至750%。轻度AMD会使普通患者的生活质量下降17%，这一下降幅度与有症状的人类免疫缺陷病毒感染或中度心绞痛患者相似。中度AMD会使生活质量下降40%，这一下降幅度与永久性肾透析或严重心绞痛患者相似。非常严重的AMD会使生活质量下降63%，这一下降幅度与伴有无法控制疼痛的晚期前列腺癌患者或导致患者卧床不起、大小便失禁且需要持续护理的严重中风患者相似。AMD的不良经济后果包括每年给加拿大国内生产总值带来26亿美元的负面影响。对于当前的AMD治疗方法和新治疗方式的研究，投资回报率都很高。
