Paulus Yannis M, Jefferys Joan L, Hawkins Barbara S, Scott Adrienne W
Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA.
Qual Life Res. 2017 Aug;26(8):2139-2151. doi: 10.1007/s11136-017-1547-z. Epub 2017 Mar 29.
To determine changes in quality of life measures when choroidal neovascularization (CNV) developed in the second eye of patients with initially unilateral neovascular age-related macular degeneration (AMD).
We analyzed responses to the 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ), 36-item Short Form Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS) at baseline, and prior to and following second eye CNV diagnosis in 92 participants enrolled in two Submacular Surgery Trials. Paired t-tests for sample sizes over 30 and Wilcoxon signed-rank tests for sample sizes <30 were performed to compare scores.
CNV development resulted in statistically and clinically significant changes in responses to 20 of 39 NEI-VFQ items, indicating visual function decline during a mean interval of 25 months. Little difference was noted between baseline scores and prior to CNV diagnosis, which averaged 8.9 months duration. Subscales demonstrated a statistically significant decline in general vision, near activities, distance activities, social functioning, role difficulties, dependency, and driving. There were minimal changes in the HADS and SF-36 scales.
CNV development in the second eye had a dramatic effect on visual functioning based on patient responses to the NEI-VFQ questionnaire. Our investigation is believed to be the first study using data collected prospectively to demonstrate vision-related quality of life changes that resulted from development of CNV in AMD patients.
确定初发为单侧新生血管性年龄相关性黄斑变性（AMD）患者的对侧眼发生脉络膜新生血管（CNV）时生活质量指标的变化情况。
我们分析了92名参与两项黄斑下手术试验的受试者在基线时、对侧眼CNV诊断之前及之后对39项美国国立眼科研究所视觉功能问卷（NEI-VFQ）、36项简明健康调查问卷（SF-36）以及医院焦虑抑郁量表（HADS）的回答。对样本量超过30的采用配对t检验，对样本量小于30的采用Wilcoxon符号秩检验来比较得分。
CNV的发生导致39项NEI-VFQ条目中的20项在统计学和临床上出现显著变化，表明在平均25个月的时间间隔内视觉功能下降。在基线得分与CNV诊断前的得分之间差异不大，CNV诊断前平均持续时间为8.9个月。各分量表显示在总体视力、近距活动、远距活动、社会功能、角色困难、依赖和驾驶方面有统计学意义的下降。HADS和SF-36量表变化极小。
基于患者对NEI-VFQ问卷的回答，对侧眼CNV的发生对视觉功能有显著影响。我们的研究被认为是第一项使用前瞻性收集的数据来证明AMD患者CNV发生所导致的与视力相关的生活质量变化的研究。
