Abstract
BackgroundDescribing the natural course of neovascular age-related macular degeneration (nAMD) is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies.MethodsFirst, we performed a literature search in PubMed, Embase, and Cochrane. We included randomized clinical trials and prospective observational studies reporting visual acuity (VA) in non-treated patients, 24 studies in total. We integrated VA data using best fit on Lineweaver-Burke plots and modelled with non-linear regression using reciprocal terms. Second, we performed a quality-of-life (QoL) study in nAMD patients. We measured VA with Radner reading charts and QoL with the Health Utilities Index issue 3 (HUI-3) questionnaire in 184 participants. We studied the relation VA-QoL with linear regression. Third, with Monte Carlo simulation, we integrated the VA model from the literature review and the relation VA-QoL from the QoL study.ResultsVisual acuity was 0.4 and 0.07 after 5 years in the better-seeing, and worse-seeing eye, respectively. After 4.3 years, VA was <0.5 in the better-seeing eye; <0.3 after 7 years; 0.05 after 17 years. QoL score decreased from 0.6 to 0.45 after 10 years.ConclusionsThe natural course of nAMD in both eyes needs to be considered when informing patients. Visual acuity in the best eye decreases to below 0.5 in 4.3 years. This affects QoL significantly.
Highlights
Describing the natural course of neovascular age-related macular degeneration is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies
Exclusion criteria were: disease studied other than neovascular age-related macular degeneration (nAMD); publication types such as reviews and conference abstracts; visual acuity (VA) not reported as outcome; only treated patients described; the lesion types not being specified; Languages used other than Dutch; English; French; German and Spanish
The model defined by the reciprocal terms from analysis that includes all studies and lesion types is used in the Monte Carlo simulation to calculate VA over time
Summary
Describing the natural course of neovascular age-related macular degeneration (nAMD) is essential in discussing prognosis and treatment options with patients and to support cost-effectiveness studies. Neovascular age-related macular degeneration (nAMD) is a common disorder of the ageing eye. Left untreated, it leads to severe central visual impairment. “Will I become blind?” is a question patients with nAMD commonly have. Blindness is feared among patients [1]. Legal blindness of the affected eye is inevitable when nAMD is left untreated. Answering questions regarding the outcome of nAMD requires making predictions. Predicting prognosis is one of the most challenging aspects of clinical medicine, for several
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
