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Association between visual functioning and death in AMD

Article

Researchers investigated the relationship between visual functioning measured using the National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and mortality in patients with various stages of AMD.

Laughing seniors sitting together playing a card game (Adobe Stock / pressmaster)

Multivariable analysis showed that for each 10-point increase in a patient’s VFQ-25 scores for general health and driving, the risk of death decreased with a hazard ratio of 0.85 (95% confidence intervals (CIs): 0.80, 0.91, P<0.0001) and 0.92 (95% CI: 0.87, 0.97, P=0.005), respectively. (Adobe Stock / pressmaster)

Sophie E. Smith, BA, and colleagues from the Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, examined a population of patients with age-related macular degeneration (AMD) and reported that better general health and ability to drive were each separately associated with a lower risk of death.1

In this observational cohort study conducted in patients from July 9, 2014, to December 31, 2021, the researchers investigated the relationship between visual functioning measured using the National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and mortality in patients with various stages of AMD.

The AMD stages were classified as follows: early AMD, intermediate AMD, geographic atrophy (GA), neovascular AMD (NV), or both advanced types of AMD (NV and GA both present).

The main outcome measures were the all-cause mortality statistics obtained through a collaborative agreement with the Colorado Department of Public Health and Environment. The investigators compared the death rates through October 19, 2022, by demographics and potential confounders.

The patient cohort included 876 patients, of whom 180 (20.6%) died during the follow-up period (average, 52.5 months).

Univariate analysis showed that the composite VFQ-25 score and all subscale scores except for ocular pain were correlated significantly with time to mortality. Additionally, age, AMD category, marital status, history of smoking, and multiple chronic comorbid conditions were associated significantly with time to mortality.

Multivariable analysis showed that for each 10-point increase in a patient’s VFQ-25 scores for general health and driving, the risk of death decreased with a hazard ratio of 0.85 (95% confidence intervals (CIs): 0.80, 0.91, P<0.0001) and 0.92 (95% CI: 0.87, 0.97, P=0.005), respectively. Composite and other subscale scores were not significantly associated with mortality after adjusting for confounding variables, the authors reported.

“This cohort of patients with AMD had a 20% rate of death in the 52.5-month average follow-up time,” investigators said. “Better general health and ability to drive, as measured by the VFQ-25, were each separately associated with significantly lower risk of death among individuals with AMD.”

Reference
1. Smith SE, Lynch AM, Auer E, et al. Visual Functioning and Mortality of Age-Related Macular Degeneration Patients in a Colorado Cohort. Investigative Ophthalmology & Visual Science. 2023;64(8):1752-1752. Accessed July 10, 2023. https://iovs.arvojournals.org/article.aspx?articleid=2790146
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