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Title: Quality-of-life and clinical outcomes in age-related macular degeneration
Author: Cassels, Nicola
ISNI:       0000 0004 7228 8832
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2017
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Age-related macular degeneration (AMD) is of increasing concern given the ageing population, and the associated economic and social burdens. Vision-related quality-of-life (QoL) is arguably one of the most important factors in the management of those with AMD. Consequently, there is a clear need for an understanding of the clinical outcomes that influence vision-related QoL in order to inform management strategies. The principle aim of the studies described herein was to determine the factors that predict vision-related QoL in those with AMD, over 1 year. Experimental procedures were undertaken at baseline (n=52 individuals with AMD) and repeated after 1 year (n=32 individuals with AMD). These included: visual acuity, contrast sensitivity, reading speed, microperimetry, optical coherence tomography and fundus photography. A questionnaire interview included assessment of vision-related QoL (Impact of Visual Impairment questionnaire), health status (EQ-5D), level of depressive symptoms (PHQ-9) and well-being (Warwick-Edinburgh Well-Being Scale). At baseline, the optimum multiple regression model accounted for 41% of the variance in vision-related QoL and included Mean Total Deviation or Mean Sensitivity with level of depressive symptoms. After 1 year, the optimum model to predict change in vision-related QoL accounted for 43% of the variance and included baseline contrast sensitivity and change in health status and reading speed. The most clinically useful measures of visual function, in identifying those with a reduced QoL or those at risk of a reduced QoL were contrast sensitivity, microperimetry, and reading speed. These outcomes may allow a better understanding of vision-related QoL if they were adopted in a clinical setting. In conclusion, the studies provide sufficient evidence to encourage a review of the clinical outcome measures most relevant to vision-related QoL.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RE Ophthalmology