Soubrane Gisèle, Cruess Alan, Lotery Andrew, Pauleikhoff Daniel, Monès Jordi, Xu Xiao, Zlateva Gergana, Buggage Ronald, Conlon John, Goss Thomas F
Department of Ophthalmology, University Paris XII, Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, Créteil, France.
Arch Ophthalmol. 2007 Sep;125(9):1249-54. doi: 10.1001/archopht.125.9.1249.
To describe the burden of bilateral neovascular age-related macular degeneration (NV-AMD) on patient-reported functioning and health resource utilization.
A cross-sectional study of 401 patients with bilateral NV-AMD and 471 elderly control subjects without AMD was conducted in 5 countries. Subjects completed a telephone survey, including the National Eye Institute 25-Item Visual Function Questionnaire, the EuroQol instrument, the Hospital Anxiety and Depression Scale, and history of falls, fractures, and health care resource utilization.
The mean age for patients with NV-AMD was 78.1 years, and 65% were women. The patients reported 45% worse vision-related functioning, 13% worse overall well-being, and 30% more anxiety and 42% more depression symptoms than controls after adjusting for covariates (all, P < .001). The effect of NV-AMD was also observed as a doubled fall rate (16% vs 8% [P < .001]) and a quadrupled need for assistance with daily activities (29% vs 7% [P < .001]) in the patients compared with controls.
The evidence of extensive decline in quality of life and increased need of daily living assistance for patients with NV-AMD compared with a control population substantiates the need for new treatments that prevent vision loss and progression to blindness.
描述双侧新生血管性年龄相关性黄斑变性（NV-AMD）对患者报告的功能和健康资源利用的负担。
在5个国家对401例双侧NV-AMD患者和471例无AMD的老年对照者进行了一项横断面研究。受试者完成了一项电话调查，包括美国国立眼科研究所25项视觉功能问卷、欧洲五维度健康量表、医院焦虑抑郁量表，以及跌倒、骨折和医疗资源利用史。
NV-AMD患者的平均年龄为78.1岁，65%为女性。在调整协变量后，患者报告的与视力相关的功能比对照组差45%，总体幸福感差13%，焦虑症状多30%，抑郁症状多42%（均P<0.001）。与对照组相比，还观察到NV-AMD患者的跌倒率增加了一倍（16%对8%[P<0.001]），日常生活需要协助的需求增加了两倍（29%对7%[P<0.001]）。
与对照人群相比，NV-AMD患者生活质量大幅下降且日常生活协助需求增加的证据，证实了需要有预防视力丧失和失明进展的新治疗方法。
