Influence of photodynamic therapy for age related macular degeneration upon subjective vision related quality of life


Background. Photodynamic therapy (PDT) has been used in the treatment of choroidal neovascularisation secondary to age-related macular degeneration (AMD). This study prospectively investigated patients' subjective change in visual function following PDT as treatment for AMD.

Methods. Eighty-two consecutive patients receiving PDT in Tasmania, Australia, between May and November 2003 were recruited. In conjunction with a comprehensive clinical examination, the Visual Function-14 (VF-14) questionnaire was administered. Final follow-up occurred between February and March 2005. The VF-14 was scored by traditional summary scoring and by Rasch analysis.

Results. Five of the 82 (6.1%) subjects recruited were excluded from analysis. PDT was performed on average 5.7 ±2.6 times per patient. Raw VF-14 scores tended towards being significantly lower at follow-up than at baseline (67.6 ±27.2 against 64.5 ±27.7; P=0.052), and did significantly deteriorate using a collapsed Rasch analysis (P=0.0102). Following treatment, 38 (47.5%) eyes had lost three or more Snellen lines of best-corrected visual acuity.

Figure 1
Figure 1. The change in Snellen BCVA following PDT

Conclusion. Patients undergoing PDT typically report reasonable visual function. In parallel with visual acuity, self-reported visual function may deteriorate slightly after PDT for AMD, but not as much as reported in untreated AMD.

Keywords Choroidal neovascularisation, Visual disability, Rasch analysis, Visual function, Verteporfin

Graefe's Arch Clin Exp Ophthalmol (Clinical Investigation)
DOI 10.1007/s00417-005-0218-x

Accepted for publication 16 November 2005.

Alex W. Hewitt1, V. Swetha Jeganathan1, Juanita E. Kidd3,
Konrad Pesudovs2, Nitin Verma1,3

1 Department of Ophthalmology, Royal Hobart Hospital, 7000 Tasmania, Australia
2 NH&MRC Centre for Clinical Eye Research, Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia
3 Hobart Eye Surgeons, Tasmania, Australia

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