Surgical Removal vs Observation for Idiopathic or Ocular Histoplasmosis Syndrome–Associated Subfoveal Choroidal Neovascularization

Abstract

To determine whether patients receiving observation vs surgery for subfoveal choroidal neovascularization that was idiopathic or associated with histoplasmosis differed in preference values assigned to their health and vision status. Before and after enrollment, patients rated their current vision on a scale from 0 (blind) to 100 (perfect vision) and rated blindness and perfect vision on a scale from 0 (dead) to 100 (perfect health and vision). Scores for current vision were converted to a preference value scale (0 represents death; 100, perfect health and vision). In 170 patients, no significant difference existed between the observation and surgery arms in median vision preference values at baseline (74 vs 70) or at the 12- (74 vs 78) or 24-month follow-up (77 vs 73) (P > .05). Preference values did not differ between arms for subgroups defined by age, unilateral vs bilateral choroidal neovascularization, or good vs poor baseline visual acuity. Submacular surgery was no better than observation in the preference values patients assigned to their health status, despite previously reported improvements in vision-specific quality of life. (clinicaltrials.gov) Identifier: NCT00000150. Ophthalmologists should consider the effects on different measures of quality of life when determining treatment for patients similar to those in the Submacular Surgery Trials Group H Trial.