Patients' preferences in treatment for neovascular age-related macular degeneration in clinical routine

被引:21
作者
Finger, Robert [2 ,3 ]
Hoffmann, Andrea E. [1 ]
Fenwick, Eva K. [2 ]
Wolf, Armin [1 ]
Kampik, Anselm [1 ]
Kernt, Marcus [1 ]
Neubauer, Aljoscha S. [1 ]
Hirneiss, Christoph [1 ]
机构
[1] Univ Munich, Dept Ophthalmol, D-80336 Munich, Germany
[2] Univ Melbourne, Royal Victorian Eye & Ear Hosp, Ctr Eye Res Australia, Melbourne, Vic, Australia
[3] Univ Bonn, Dept Ophthalmol, Bonn, Germany
关键词
QUALITY-OF-LIFE; VISION-RELATED FUNCTION; RANIBIZUMAB TREATMENT; SURGERY; UTILITY; ANCHOR; TRIAL;
D O I
10.1136/bjophthalmol-2011-301201
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose To assess the effect of ranibizumab treatment for neovascular age-related macular degeneration (nvAMD) on patients' preferences and vision-related quality of life (VRQoL) in a routine clinical setting. Methods 55 treatment naive patients were examined before and after the initial upload of three monthly injections of 0.5 mg ranibizumab. VRQoL was assessed using a Rasch-adjusted NEI-VFQ-25. Time trade-off (TTO), standard gamble, a visual analogue scale and the European Quality of Life Questionnaire (EQ-5D) were used to calculate utilities, and multiple logistic regression models were conducted to determine independent factors associated with utilities. Results Mean +/- SD age was 7567 years, and 40 patients (73%) were female. Mean +/- SD best-corrected visual acuity of the treated eye increased from 20/80 at baseline (logMAR 0.60 +/- 0.35) to 20/63 (logMAR 0.52 +/- 0.36; p=0.020) at follow-up after three injections. Utility score increases ranged from 2 utils (standard gamble anchored for death) up to 6.6 utils (EQ-5D German TTO, p=0.023) and visual functioning improved (Rasch adjusted composite NEI-VFQ score 50 +/- 21 to 54 +/- 21, p=0.042). Whether the worse or better eye was treated was not significantly associated with improvements in utility or VRQoL, whereas VA improvement in the treated eye was associated with an increase in utility (TTO, p=0.020). Conclusions TTO performed best in this sample of elderly nvAMD patients undergoing anti-VEGF therapy. Better or worse eye treatment was not associated with a change in reported utilities or visual functioning in patients with newly diagnosed nvAMD. Directly elicited, vision-specific utilities gained with TTO seem to be sensitive to a change in vision status.
引用
收藏
页码:997 / 1002
页数:6
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