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      Burden and health care resource utilization in neovascular age-related macular degeneration: findings of a multicountry study.

      Archives of ophthalmology (Chicago, Ill. : 1960)
      Aged, Aged, 80 and over, Canada, Choroidal Neovascularization, economics, physiopathology, Comorbidity, Cost of Illness, Cross-Sectional Studies, Europe, Female, Health Resources, utilization, Health Services Research, Humans, Macular Degeneration, Male, Middle Aged, Quality of Life, Questionnaires, Sickness Impact Profile, Visual Acuity, physiology

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          Abstract

          To describe the burden of bilateral neovascular age-related macular degeneration (NV-AMD) on patient-reported functioning and health resource utilization. A cross-sectional study of 401 patients with bilateral NV-AMD and 471 elderly control subjects without AMD was conducted in 5 countries. Subjects completed a telephone survey, including the National Eye Institute 25-Item Visual Function Questionnaire, the EuroQol instrument, the Hospital Anxiety and Depression Scale, and history of falls, fractures, and health care resource utilization. The mean age for patients with NV-AMD was 78.1 years, and 65% were women. The patients reported 45% worse vision-related functioning, 13% worse overall well-being, and 30% more anxiety and 42% more depression symptoms than controls after adjusting for covariates (all, P < .001). The effect of NV-AMD was also observed as a doubled fall rate (16% vs 8% [P < .001]) and a quadrupled need for assistance with daily activities (29% vs 7% [P < .001]) in the patients compared with controls. The evidence of extensive decline in quality of life and increased need of daily living assistance for patients with NV-AMD compared with a control population substantiates the need for new treatments that prevent vision loss and progression to blindness.

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