Influence of age-related maculopathy on visual functioning and health-related quality of life

PURPOSE: To describe the influence of age-related maculopathy on visual fun ctioning and health-related quality of life. METHODS: A prospective, cross-sectional, observational cohort sample of 201 persons with various stages of age-related maculopathy was recruited from the Massachusetts Eye and Ear Infirmary as part of a longitudinal study of age-related macular degeneration, Persons were considered to have age-relat ed maculopathy if one or more of the following clinical characteristics wer e present: drusen, retinal pigment epithelial changes, geographic atrophy, or evidence of exudative disease. Median corrected visual acuity for this s ample was 20/25 in the better eye, with all subjects having 20/200 or bette r visual acuity in at least one eye at baseline. All participants underwent a comprehensive ophthalmologic examination with a dilated pupil. In additi on to the usual clinical data collection, severity of age-related maculopat hy was graded by an ophthalmologist who used standard clinical criteria and was masked to the participants' descriptions of visual functioning and hea lth-related quality of life. All participants completed an interview that i ncluded the Activities of Daily Vision Scale, a survey designed to assess d ifficulties with routine daily activities that require vision, and the Shor t Form-36 Health Survey, a generic measure of multidimensional health-relat ed quality of life, RESULTS: Severity of age-related maculopathy was associated with poorer sco res of the Activities of Daily Vision Scale. This association was most sign ificant for near vision and driving activities. In this sample, the SF-36 H ealth Survey scales were not significantly correlated with severity of age- related maculopathy. CONCLUSIONS: Reported visual functioning is significantly associated with t he clinical severity of age-related maculopathy. However, once visual acuit y is taken into consideration, clinical grading of age-related maculopathy did not explain a significant portion of the variation in visual functionin g. The lack of significant correlation between severity of age-related macu lopathy and the SF-36 Health Survey may have resulted from the small number of participants in our sample with severe bilateral age-related maculopath y. (Am J Ophthalmol 1999; 128:4-5-53. (C) 1999 by Elsevier Science Inc. All rights reserved.)