Beyond visual acuity: functional outcome and patient satisfaction following treatment for age-related macular degeneration

Abstract

Objective: The success of current medical treatments for choroidal neovascular membranes secondary to age-related macular degeneration (AMD) has often been determined anatomically by change in lesion size and cessation of leakage. Measuring the functional success of treatments has most often revolved around visual acuity and has seldom encompassed patients'; satisfaction with treatment. Using additional objective and subjective measures to assess the outcome of treatments may provide greater insight into the visual functions that are lost, maintained, or improved during the course of treatment. Study Design: Cross-sectional study. Participants: Forty-six patients diagnosed with exudative AMD. Participants had received at least 1 photodynamic therapy (PDT) treatment at the time of testing (mean 3.0, SD 1.9) Methods: Objective tests of visual function (Snellen, Early Treatment Diabetic Retinopathy Study, Minnesota Low-Vision Reading Test, Contrast Sensitivity, Face Acuity) and a subjective questionnaire, the Visual Function-14 (VF-14) were administered to all patients. Treating ophthalmologists completed a 3-item questionnaire. Results: No objective measures of visual function correlated with patient satisfaction or with the ophthalmologists'; evaluation of treatment success. The VF-14 was not related to the ophthalmologists'; evaluation of treatment outcome. Similarly, patient satisfaction was unrelated to the ophthalmologists'; assessment of treatment success. A correlation was found between the VF-14 and patient satisfaction, r = 0.50, p < 0.05. Conclusions: Objective measures of visual function do not necessarily reflect the viewpoint of patients regarding PDT treatment outcome. Patients and doctors differ in their interpretation of treatment success and patients'; overall satisfaction might best be reflected through a visual function questionnaire.