Lotery Andrew, Xu Xiao, Zlatava Gergana, Loftus Jane
University of Southampton, Southampton Eye Unit, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Br J Ophthalmol. 2007 Oct;91(10):1303-7. doi: 10.1136/bjo.2007.116939. Epub 2007 May 15.
BACKGROUND/AIMS: Quantitative data regarding the impact of neovascular age-related macular degeneration (NV-AMD) on individuals and society is a prerequisite for rational decision-making processes when evaluating alternative treatments for the disease.
75 bilateral NV-AMD (patients) and 91 elderly non-AMD (controls) subjects forming the UK cohort of an international cross-sectional, observational study were independently analysed. Subjects completed a telephone survey including the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), the EuroQol (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), history of falls and health resource utilisation.
Patients with NV-AMD reported substantially worse vision-related functioning and overall well-being, including higher depression scores, than controls after adjusting for age, gender and co-morbidities (adjusted mean scores: NEI-VFQ-25 overall 52.7 vs 90.7, p<0.0001; EQ-5D 0.67 vs 0.77, p = 0.0273; HADS depression 6.8 vs 4.0, p = 0.0026). Significantly more patients reported a need for assistance with daily activities compared with controls (25.3% vs 6.6%, p = 0.003). Total annual healthcare utilisation costs were more than sevenfold higher for patients with AMD compared with controls ( pound 3,823.89 vs pound 517.05, respectively; p<0.0001)
Patients with NV-AMD show a significant decline in quality of life and increased need for daily living assistance compared to a control population without AMD. With the availability of effective new therapies there is a need for improved early access to treatment.
背景/目的:在评估新生血管性年龄相关性黄斑变性(NV-AMD)的替代治疗方法时,有关该疾病对个人和社会影响的定量数据是合理决策过程的先决条件。
对国际横断面观察性研究英国队列中的75例双侧NV-AMD患者和91例老年非AMD(对照)受试者进行独立分析。受试者完成了一项电话调查,包括国立眼科研究所视觉功能问卷(NEI-VFQ-25)、欧洲五维健康量表(EQ-5D)、医院焦虑抑郁量表(HADS)、跌倒史和卫生资源利用情况。
在调整年龄、性别和合并症后,NV-AMD患者报告的视力相关功能和总体幸福感明显比对照组差,包括抑郁得分更高(调整后平均得分:NEI-VFQ-25总体为52.7对90.7,p<0.0001;EQ-5D为0.67对0.77,p = 0.0273;HADS抑郁为6.8对4.0,p = 0.0026)。与对照组相比,报告需要日常生活活动协助的患者明显更多(25.3%对6.6%,p = 0.003)。AMD患者的年度医疗总费用比对照组高出七倍多(分别为3823.89英镑对517.05英镑;p<0.0001)
与无AMD的对照人群相比,NV-AMD患者的生活质量显著下降,对日常生活协助的需求增加。随着有效新疗法的出现,需要改善早期治疗的可及性。