Factors affecting quality of life in patients with neovascular age-related macular degeneration

Purpose: This study examines how factors such as age, sex, best corrected visual acuity (BCVA), driving ability, and perceived treatment effectiveness influence quality of life (QoL) among patients with neovascular age-related macular degeneration (nAMD) in treatment with anti-vascular endothelial growth factor (VEGF) injections. Such information might be invaluable for healthcare providers, enabling them to understand who benefits from treatment. Design: Survey-based cross-sectional study Methods: We used questionnaire responses from patients receiving intravitreal anti-VEGF injections for nAMD to evaluate self-reported QoL, measured by the Macular Degeneration Quality of Life questionnaire. Background questions in the survey gathered patient information, while BCVA was obtained from medical records. The associations between self-rated QoL and various factors were analyzed using binomial logistic regression and linear regression. We calculated crude odds ratio (OR) and β-coefficient as well as OR and β-coefficient adjusted for sex, age, and BCVA. Results: This study included 348 individuals, median age 79.2 years (IQR 75.0–84.0), with 58.3 % women. In the adjusted logistic model, factors associated with a QoL above average were male sex (OR 1.65, 95 % CI 1.04, 2.63), BCVA above 0.5 Snellen in best seeing eye (OR 11.16, 95 % CI 4.24, 29.35), preserved driving ability (OR 3.35, 95 % CI 1.80, 6.26), and perceiving treatment effectiveness (OR 2.15, 95 % CI 1.07, 4.34). The adjusted linear regression revealed the same associations, yet the positive relationship between QoL and biological sex was significant in the crude model but not in the adjusted model (β: 0.30, 95 % CI -0.04, 0.64). Conclusion: Good visual acuity and driving ability strongly correlate with high QoL in patients with nAMD. Perceptions of the effectiveness of anti-VEGF treatment double the likelihood of high QoL, highlighting the need for further investigation into its potential clinical implications.