Patnaik Jennifer L, Lynch Anne M, Pecen Paula E, Jasso Maria, Hanson Kara, Mathias Marc T, Palestine Alan G, Mandava Naresh
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Acta Ophthalmol. 2021 Nov;99(7):750-755. doi: 10.1111/aos.14731. Epub 2020 Dec 30.
To assess visual function among patients diagnosed with age-related macular degeneration (AMD) by stage of disease and laterality.
This is a cross-sectional cohort study of 739 AMD patients and their responses to the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) at time of study enrolment. Patients with AMD were categorized into Early/Intermediate AMD and three groups of advanced AMD: (i) neovascular AMD (NV), (ii) geographic atrophy (GA) and (iii) Both Advanced forms. These three advanced stages were further stratified into unilateral or bilateral advanced disease. Mean composite scores and subscale scores for 12 different areas were based on a 100-point scale with the lowest and highest possible scores set at 0 and 100, respectively. Scores for the advanced AMD groups were compared with Early/Intermediate AMD using general linear modelling.
A total of 739 AMD patients (294 Early/Intermediate, 115 GA, 168 NVAMD and 162 Both Advanced) were included in the analysis. Mean composite scores were highest among Early/Intermediate patients (89.9), followed by patients diagnosed with unilateral disease in the Both Advanced (88.0) and NV (86.1) groups. Mean composite scores were similar for bilateral NV (82.9) and unilateral GA (81.7), and mean scores were lowest for the bilateral GA (71.3) and bilateral Both Advanced (68.5) groups. In general, this pattern persisted across the twelve subscales as well. Subscale scores ranged from a low of 35.1 for driving among bilateral Both Advanced patients to a high of 99.2 for colour vision among patients with unilateral Both Advanced. Overall, patients with unilateral advanced disease consistently had higher mean scores than their bilateral counterparts. The largest difference was 19.5 composite score points between the unilateral and bilateral Both Advanced groups, there was a difference of 10.4 points between the GA groups, and a relatively small difference of 3.2 points between the NV groups.
We found large differences in visual function as reported from the VFQ-25 across the different types of advanced stage AMD groups and number of eyes affected with advanced AMD. These findings demonstrate the importance of accounting for the type and number of eyes affected by advanced stage AMD.
按疾病阶段和病变侧别评估年龄相关性黄斑变性（AMD）患者的视觉功能。
这是一项横断面队列研究，纳入了739例AMD患者，研究入组时他们对美国国立眼科研究所视觉功能问卷25项（NEI VFQ - 25）的回答。AMD患者被分为早期/中期AMD以及三组晚期AMD：（i）新生血管性AMD（NV），（ii）地图样萎缩（GA），（iii）两种晚期形式。这三个晚期阶段进一步分为单侧或双侧晚期疾病。12个不同领域的平均综合得分和分量表得分基于100分制，最低和最高可能得分分别设定为0分和100分。使用一般线性模型将晚期AMD组的得分与早期/中期AMD组进行比较。
分析共纳入739例AMD患者（294例早期/中期，115例GA，168例NVAMD，162例两种晚期形式）。平均综合得分在早期/中期患者中最高（89.9），其次是两种晚期形式组中的单侧疾病患者（88.0）和NV组（86.1）。双侧NV（82.9）和单侧GA（81.7）的平均综合得分相似，双侧GA（71.3）和双侧两种晚期形式组（68.5）的平均得分最低。总体而言，这种模式在十二个分量表中也持续存在。分量表得分范围从双侧两种晚期形式患者中驾驶能力的35.1分到单侧两种晚期形式患者中色觉的99.2分。总体而言，单侧晚期疾病患者的平均得分始终高于双侧患者。最大差异是单侧和双侧两种晚期形式组之间综合得分相差19.5分，GA组之间相差10.4分，NV组之间相差相对较小的3.2分。
我们发现，根据VFQ - 25报告，不同类型的晚期AMD组以及受晚期AMD影响的眼数在视觉功能上存在巨大差异。这些发现证明了考虑晚期AMD影响的眼的类型和数量的重要性。
