Relationships between retinal structure and function and vision-related quality of life measures in advanced age-related macular degeneration

Faran Sabeti; Jo Lane; Emilie M F Rohan; Rohan W Essex; Elinor McKone; Ted Maddess

doi:10.1007/s00417-021-05296-9

Relationships between retinal structure and function and vision-related quality of life measures in advanced age-related macular degeneration

Graefes Arch Clin Exp Ophthalmol. 2021 Dec;259(12):3687-3696. doi: 10.1007/s00417-021-05296-9. Epub 2021 Jul 8.

Authors

Faran Sabeti^{1

2}, Jo Lane^{3

4}, Emilie M F Rohan⁵, Rohan W Essex^{6

7}, Elinor McKone^{3

4}, Ted Maddess⁵

Affiliations

¹ John Curtin School of Medical Research (JCSMR), The Australian National University, ACT, Canberra, Australia. faran.sabeti@canberra.edu.au.
² Discipline of Optometry, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia. faran.sabeti@canberra.edu.au.
³ Research School of Psychology, The Australian National University, Canberra, ACT, Australia.
⁴ ARC Centre of Excellence in Cognition and Its Disorders, The Australian National University, Canberra, ACT, Australia.
⁵ John Curtin School of Medical Research (JCSMR), The Australian National University, ACT, Canberra, Australia.
⁶ The Canberra Hospital, Canberra, Australia.
⁷ Academic Unit of Ophthalmology, ANU Medical School, Canberra, ACT, Australia.

PMID: 34236475
DOI: 10.1007/s00417-021-05296-9

Abstract

Purpose: To evaluate the association between ophthalmic structure/function measures and five standardized quality of life (QoL) instruments, in patients with advanced age-related macular degeneration (AMD).

Methods: We examined 20 AMD patients (ages 66-93 years) recruited from the Canberra Hospital Ophthalmology Department. Visual function measures included low and high contrast visual acuity (LCVA and HCVA) and measures from 10-2 Matrix visual fields (VF). Optical coherence tomography (OCT) quantified central retinal thickness (CRT), average macular thickness (AT), and retinal nerve fibre layer thickness (RNFL). The QoL instruments were the macular degeneration-related quality of life (MacDQoL), the National Eye Institute Visual Functioning Questionnaire (VFQ), its two face-recognition questions (A6 and 11), and the Geriatric Depression Scale (GDS). Pearson correlations, Canonical Correlation Analysis (CCA), and cross-validated stepwise-regression were used to examine the relationships between structure/function measures and the QoL instruments.

Results: The selected models for the five instruments had R² ranging from 0.65 ± 0.12 to 0.90 ± 0.05 (mean ± SD) and median F-statistics > 188. HCVA was strongly associated with all QoL except the GDS, for which CRT, AT and RNFL figured highly. RNFL was most important for MacDQoL, and 2^nd for VFQ question-A6. Centrally weighted VF measures were rarely selected but global VF measures were common, especially for the overall NEI-VFQ questionnaire. CCA revealed that the structure/function measures and QoL instruments contained 2 statistically independent mechanisms.

Conclusions: In patients with advanced AMD, CRT and HCVA were strong determinants of QoL instruments in AMD patients.

Keywords: Age-related macular degeneration; Quality of life; Retinal function; Retinal structure.

MeSH terms

Aged
Aged, 80 and over
Cross-Sectional Studies
Humans
Macular Degeneration* / diagnosis
Quality of Life*
Retina
Surveys and Questionnaires
Tomography, Optical Coherence
Visual Acuity

Grants and funding

PG2018040/Rebecca L. Cooper Medical Research Foundation