Abstract

To investigate the impact of non-neovascular (dry) age-related macular degeneration (AMD) on the person with respect to diagnosis, vision loss and coping strategies. Volunteers with dry AMD with a range of disease severity were given an eye examination and asked to describe aspects of their experience with dry AMD in a semi-structured interview. Interviews were audio-recorded, transcribed, and subjected to Framework analysis. Overarching themes were pre-defined, whilst subthemes were derived from the data. Twenty-seven participants (81% female), with early (n = 3), intermediate (n = 16) and advanced dry AMD (GA; n = 8) were interviewed. Median (interquartile range) age (years), logMAR binocular visual acuity and Pelli-Robson contrast sensitivity were 76 (71, 80), 0.2 (0.18, 0.40) and 1.65 (1.35, 1.93), respectively. Overarching themes (and subthemes) were: diagnosis (relationship with healthcare professional, psychological impact of diagnosis, and knowledge of AMD, both pre- and post-diagnosis), impact of visual loss (functional and psychological) and coping strategies (help from others and personal strategies). Many participants reported feelings of distress at the time of diagnosis and, particularly noteworthy, several reported a constant fear of their condition worsening. Dry AMD, for which there is currently no treatment, can have a significant impact on individuals, even in its early stages, before significant functional vision loss is manifest, as well as in its intermediate and advanced stages. Results from this study offer important insight into the experience of living with dry AMD not previously explored. Moreover, the results have the potential to serve as an educational resource for eyecare professionals.

Highlights

  • Non-neovascular, or dry age-related macular degeneration (AMD) is a gradually progressive, incurable, sightthreatening condition

  • The insidious nature of dry AMD means that diagnosis may occur before the patient is aware of any visual disturbances. We suggest that this may have a psychological impact on the patient which differs to that of neovascular AMD (nAMD)

  • We propose that the patient journey in dry AMD is unique and worthy of further investigation; this is the subject of this study

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Summary

Introduction

Non-neovascular, or dry age-related macular degeneration (AMD) is a gradually progressive, incurable, sightthreatening condition. Living with dry AMD remains relatively neglected in the literature. Effects of dry AMD on performance of activities of daily living are becoming better appreciated through both patient-reported outcome measures and performancebased studies [3]. A more explorative approach to understanding the experience of people living with a condition is through qualitative methods [4]. Studies adopting qualitative methodologies are underrepresented in ophthalmology journals [9]

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