Association of Lesion Location and Functional Parameters with Vision-Related Quality of Life in Geographic Atrophy Secondary to Age-related Macular Degeneration

Sandrine H Künzel; Eliza Broadbent; Philipp T Möller; Moritz Lindner; Lukas Goerdt; Joanna Czauderna; Steffen Schmitz-Valckenberg; Frank G Holz; Maximilian Pfau; Monika Fleckenstein

doi:10.1016/j.oret.2024.01.025

Association of Lesion Location and Functional Parameters with Vision-Related Quality of Life in Geographic Atrophy Secondary to Age-related Macular Degeneration

Ophthalmol Retina. 2024 Feb 3:S2468-6530(24)00057-5. doi: 10.1016/j.oret.2024.01.025. Online ahead of print.

Affiliations

¹ Department of Ophthalmology, University of Bonn, Bonn, Germany. Electronic address: sandrine.kuenzel@ukbonn.de.
² Department of Ophthalmology & Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
³ Department of Ophthalmology, University of Bonn, Bonn, Germany.
⁴ Department of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps University, Marburg, Germany; Nuffield Laboratory of Ophthalmology, Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
⁵ Department of Ophthalmology, University of Bonn, Bonn, Germany; Department of Ophthalmology & Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
⁶ Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland.

PMID: 38311207
DOI: 10.1016/j.oret.2024.01.025

Abstract

Objective: The primary goal of this study was to determine how structural and functional parameters influence the vision-related quality of life (VRQoL) in patients suffering from geographic atrophy (GA) secondary to age-related macular degeneration.

Design: This study was designed as a prospective, noninterventional, natural-history study (Directional Spread in Geographic-Atrophy study, NCT02051998).

Subjects: The research involved 82 patients with bilateral GA.

Methods: The study examined parameters including GA location as assessed by the ETDRS grid, best-corrected visual acuity, low-luminance visual acuity (LLVA), reading acuity, and speed. These parameters were then correlated with VRQoL, which was gauged using the National Eye Institute Visual Function Questionnaire 25. The analysis method employed was the least absolute shrinkage and selection operator with linear mixed-effects models.

Main outcome measures: The central parameters measured in this study encompassed GA area, VRQoL scores associated with different GA subfields, and the significance of LLVA for foveal-sparing patients.

Results: On average, patients showed a total GA area of 2.9 ± 1.2 mm² in the better eye (BE) and 3.1 ± 1.3 mm² in the worse eye. The most significant associations with VRQoL scores for distance and near activities were observed in the inner lower and inner left subfields of the BE, respectively. For patients with foveal-sparing GA, the LLVA of the BE stood out as the most influential variable across all VRQoL scales.

Conclusions: The study's findings point toward the pivotal role of GA location, especially the inner lower and inner left subfields of the BE, in relation to VRQoL in GA patients. The LLVA's importance becomes even more pronounced for foveal-sparing patients. These observations highlight the need for health care professionals to better understand the association between lesion location and patient-reported outcomes. This is critical for informing treatment decisions and refining the planning of interventional trials.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Age-related macular degeneration; Geographic atrophy; Patient-reported outcomes; Quality of life; Vision-related quality of life.

Associated data

ClinicalTrials.gov/NCT02051998