Sains Malaysiana
47(10)(2018): 2447–2454
http://dx.doi.org/10.17576/jsm-2018-4710-21
Quality
of Life in Patients with Neovascular
Age Related Macular Degeneration (n-AMD) Seen in a Public Hospital
of Malaysia
(Kualiti Hidup Pesakit dengan
Neovascular Degenerasi
Makular Berkaitan Umur (n-AMD) yang dilihat Hospital Awam di Malaysia)
Rituparna Ghoshal1, Sharanjeet Kaur1*,
Norliza Mohamad Fadzil1, Somnath Ghosh1,
NorFariza Ngah1 & Roslin Azni Binti Abd Aziz2
1Optometry & Vision Science Program,
School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia,
Jalan Raja Muda Abd Aziz, 50300
Kuala Lumpur, Federal Territory, Malaysia
2Department of Ophthalmology, Hospital Shah Alam, Persiaran
Kayangan, Seksyen 7, 40000 Shah Alam, Selangor Darul Ehsan, Malaysia
Received:
29 January 2018/Accepted: 20 June 2018
ABSTRACT
The
purpose of the present study was to assess quality of life (QOL)
in n-AMD patients seen in a Malaysian public hospital and to
further identify visual and demographic factors that may contribute
to QOL
scores of these patients. Patients with any form
of n-AMD in
at least one eye were recruited from hospital’s ophthalmology
department. Bahasa Malaysia version of National Eye Institute
Visual function questionnaire-25 (NEI-VFQ-25) was administered to all participants.
Demographics, visual functions (VF)
including best corrected distance visual acuity (BCDVA),
contrast sensitivity (CS), near visual acuity (NVA)
and reading speed (RS) were recorded. Eighty-six patients
(Malay=26, Indian=23, Chinese=37) aged 52 to 85 years, diagnosed
with n-AMD
were chosen to participate. Their mean NEI-VFQ composite score (NEI-VFQ
CS) was 66.91 ± 13.07. However, no significant difference
in NEI-VFQ
CS between gender, races and between the two sub
groups of n-AMD
were observed (p>0.05). NEI-VFQ CS showed a significant
association with RS (correlation coefficient (ρ)
=0.627), NVA (ρ = -.660), BCDVA (ρ
= -.586), CS (ρ =.0.515). A linear model showed that a
combination of BCDVA, NVA,
CS
is accounted for a significant 38 % variability
of NEI-VFQ CS (R2 =0.382,
p<0.001). In conclusion, the QOL of Malaysian n-AMD
patients were found to be low. Thus, the study results
indicated the need of developing necessary management strategies
to address this QOL issues
in n-AMD patients in Malaysia. Furthermore, the present study
suggested incorporating appropriate VF such as near acuity, contrast
sensitivity, reading speed in clinical settings while assessing
n-AMD
patients as these VF explain the patient’s perception about the impact of
this disease.
Keywords:
Neovascular AMD (n-AMD);
visual functions (VF); vision targeted quality of life
(VTQOL)
ABSTRAK
Tujuan penyelidikan ini
adalah untuk
menilai kualiti hidup (QOL) dalam
pesakit n-AMD yang mendapat
rawatan di hospital awam
Malaysia dan seterusnya
mengenal pasti faktor visual dan demografi yang mungkin menyumbang kepada markah QOL bagi pesakit ini. Pesakit yang mempunyai n-AMD pada sekurang-kurangnya satu mata telah
diambil daripada
jabatan oftalmologi hospital.
Soal
selidik-25 (NEI-VFQ-25) fungsi Institut Visual Mata Nasional versi
Bahasa Malaysia diberikan kepada
semua peserta.
Demografi, fungsi visual (VF) termasuk
jarak visual ketajaman
diperbetulkan terbaik (BCDVA),
sensitiviti kontra
(CS),
ketajaman visual dekat
(NVA)
dan kelajuan
bacaan (RS) telah
direkodkan. Enam
puluh lapan pesakit
(Melayu = 26, India = 23, Cina
= 37) berumur antara
52 dan 85 tahun, didiagnos
dengan n-AMD telah
memilih untuk
mengambil bahagian. Min skor komposit
NEI-VFQ
(NEI-VFQ CS) mereka
ialah 66.91 ± 13.07. Walau bagaimanapun,
tiada perbezaan
yang signifikan dalam NEI-VFQ CS antara jantina, kaum dan antara
dua kumpulan
kecil n-AMD diperhatikan
(p> 0.05). NEI-VFQ CS menunjukkan hubungan bererti dengan RS (pekali korelasi (ρ) =0.627), NVA (ρ = -.660 ), BCDVA (ρ = -.586 ), CS
(ρ =.0.515 ). Model linear menunjukkan
bahawa gabungan BCDVA,
NVA,
CS
menerangkan perbezaan
38% CS NEI-VFQ (R2 = 0.382, p< 0.001)
yang ketara. Kesimpulannya, QOL n-AMD pesakit
Malaysia didapati adalah
rendah. Oleh itu, keputusan
kajian menunjukkan
perlunya keperluan membangunkan strategi pengurusan untuk mengatasi isu QOL pada pesakit n-AMD di
Malaysia. Selain itu, kajian kini mencadangkan penggabungan VF yang sesuai
seperti ketajaman
dekat, sensitiviti kontra, kelajuan membaca dalam situasi
klinikal sambil
menilai pesakit n-AMD apabila VF ini
menerangkan kepada
persepsi pesakit tentang kesan penyakit
ini.
Kata kunci: Fungsi
visual (VF); neovaskular AMD
(n-AMD);
Visi sasaran
kualiti hidup (VTQOL)
REFERENCES
Berdeaux,
G.H., Nordmann, J.P., Colin, E. &
Arnould, B. 2005. Vision-related quality of life in patients suffering from age-related
macular degeneration. Am. J. Ophthalmol.
139(2): 271-279.
Bertelmann,
T., Feltgen, N., Scheffler,
M., Hufenbach, U., Wiedon,
A., Wilhelm, H. & Ziemssen, F. 2016. Vision-related
quality of life in patients receiving intravitreal ranibizumab injections in routine clinical practice: Baseline
data from the German OCEAN study. Health Qual. Life Outcomes
14(1): 132.
Broman, A.T., Munoz, B., West, S.K., Rodriguez,
J., Sanchez, R., Snyder, R. & Klein, R. 2001. Psychometric
properties of the 25-item NEI-VFQ in a hispanic population: Proyecto VER. Investig. Ophthalmol. Vis. Sci. 42(3): 606-613.
Brown, G.C., Brown, M.M., Sharma, S., Stein,
J.D., Roth, Z., Campanella, J. &
Beauchamp, G.R. 2005. The burden of age-related macular degeneration:
A value-based medicine analysis. Trans. Am. Ophthalmol. Soc. 103: 173-184 & 186.
Buari,
N.H., Yusof, N.H., Mohd-Satali,
A. & Chen, A.H. 2015. Repeatability of the Universiti Teknologi MARA reading
charts. Bangladesh J. Med. Sci. 14(3): 226-240.
Centers for Disease Control and Prevention. 2013. Centers for Disease Control and Prevention.
Health Related Quality of Life (HRQOL).
Clemons, T.E., Chew, E.Y., Bressler, S.B. & McBee, W. 2003.
National eye institute visual function questionnaire in the age-related
eye disease study (AREDS): AREDS Report No. 10. Arch. Ophthalmol.
121(2): 211-217.
Chandramohan,
H., Halim, W.H.W.A., Azizi, H.A., Tiak,
H.S., Rain, S.L.Z., Rahman, G. Y.A. & Khialdin,
S.M. 2017. Quality of life and severity of glaucoma: A study
using Glaucol-36 questionnaire at Universiti
Kebangsaan Malaysia Medical Centre (UKMMC). International
Medical Journal 24(1): 61-64.
Dawson, S.R., Mallen,
C.D., Gouldstone, M.B., Yarham,
R. & Mansell, G. 2014. The prevalence of anxiety and depression
in people with age-related macular degeneration: A systematic
review of observational study data. BMC Ophthalmol.
14(1): 78.
Fenwick, E.K., Cheung, C.M.G., Ong, P.G.,
Tan, G., Lee, S.Y., Yeo, I., Cheng, C.Y., Wong, T.Y. & Lamoureux, E.L. 2017a. The impact of typical neovascular age-related
macular degeneration and polypoidal
choroidal vasculopathy on vision-related
quality of life in Asian patients. Br. J. Ophthalmol.
101(5): 591-596.
Fenwick,
E.K., Man, R.E.K., Cheung, C.M.G., Sabanayagam,
C., Cheng, C.Y., Neelam, K., Chua, J.,
Gan, A.T.L., Mitchell, P., Wong, T.Y. & Lamoureux, E.L. 2017b. Ethnic differences
in the association between age-related macular degeneration and
vision-specific functioning. JAMA
Ophthalmol. 169856(5): 469-476.
Hassell,
J.B., Lamoureux, E.L. & Keeffe,
J.E. 2006. Impact of age related macular degeneration on quality
of life. Br. J. Ophthalmol. 90(5):
593-596.
Li,
Y., Xu, L., Wang, Y.X., You, Q.S., Yang, H. & Jonas, J.B.
2008. Prevalence of age-related maculopathy in the adult population
in China: The Beijing Eye Study. Am. J. Ophthalmol.
146(2): 329.
Mangione,
C.M., Lee, P.P., Pitts, J., Gutierrez, P., Berry, S. & Hays,
R.D. 1998. Psychometric properties of the National Eye Institute Visual Function
Questionnaire (NEI-VFQ). NEI-VFQ Field
Test Investigators. Arch Ophthalmol.
116(11): 1496-1504.
Mangione, C.M.,
Lee, P.P., Gutierrez, P.R., Spritzer, K., Berry, S. & Hays,
R.D. 2001.
Development of the 25-item National Eye Institute
Visual Function Questionnaire. Arch
Ophthalmol (Chicago, Ill 1960).
119(7): 1050-1058.
Martin, D.F., Maguire, M.G., Ying, G., Grunwald,
J.E., Fine, S.L. & Jaffe, G.J. 2011.
Ranibizumab and bevacizumab for neovascular age-related
macular degeneration. N. Engl. J. Med. 364(20):
1897-908.
Matamoros,
E., Maurel, F., Léon, N., Solomiac,
A., Bardoulat, I., Joubert,
M., Hermans, M., Moser, E., Le Picard,
S., Souied, E.H. & Leveziel, N.
2015. Quality of life in patients suffering from active exudative
age-related macular degeneration: The EQUADE study. Ophthalmol. J. Int. d’ophtalmologie
Int. J. Ophthalmol. Zeitschrift für
Augenheilkd.
234(3): 151-159.
McCloud, C. & Lake, S.C.M. 2015. Understanding
the patient’s lived experience of neovascular
age-related macular degeneration: A qualitative study. Eye
(Lond). 29(12): 1561-1569.
Mitchell, J. & Bradley, C. 2006. Quality
of life in age-related macular degeneration: A review of the literature.
Health Qual. Life Outcomes 4(1): 97.
Mohamad,
N.A., Ramachandran, V., Ismail, P., Mohd Isa, H., Chan, Y.M.,
Ngah, N.F., Bakri, N. Md., Ching, S.M., Hoo,
F.K. & Sulaiman, W.A. 2017. Prevalence
and treatment patterns of ranibizumab
and photodynamic therapy in a tertiary care setting in Malaysia.
International Journal of Ophthalmology 10(12): 1889-1897.
Nazima,
S.A., Hanisah, A.H., Rona, A.N., Wong,
H.S., Amin, A., Bastion, M.L.C., Mushawiahti,
M. & Hazlita, M.I. 2016. Patterns of polypoidal choroidal vasculopathy among a multiracial population in a Malaysian
hospital. Medicine & Healt.
11(2): 245-256.
Omar, R., Rahman, M.H.A., Knight, V.F.,
Mustaphal, M. & Mohammed, Z. 2014. Mental
health state and quality of life questionnaire in low vision assessment:
A case report. BMC Research Notes 7: 667.
Orr,
P., Rentz, A.M., Margolis, M.K., Revicki,
D.A., Dolan, C.M., Colman, S., Fine, J.T. & Bressler,
N.M. 2011. Validation of the national eye institute visual function
questionnaire-25 (NEI VFQ-25) in age-related macular degeneration.
Invest Ophthalmol. Vis. Sci. 52(6): 3354-3359.
Oshima,
Y., Ishibashi, T., Murata, T., Tahara,
Y., Kiyohara, Y. & Kubota, T. 2001. Prevalence
of age related maculopathy in a representative Japanese population:
The Hisayama study. Br. J. Ophthalmol.
85(10): 1153-1157.
Paulus, Y.M., Jefferys,
J.L., Hawkins, B.S. & Scott, A.W. 2017. Visual function
quality of life measure changes upon conversion to neovascular
age-related macular degeneration in second eyes. Qual. Life
Res. 26(8): 2139-2151.
Rahman,
M.B.A. 2015. Cross Cultural Adaptation of English Version Vision-Specific
Patient-Reported Outcome Measures (PROMs) in a Malaysian Glaucoma
Population (Thesis) (Unpublished).
Rebollo,
P. & Ortega, F. 2001. New trends on health related quality of
life assessment in end-stage renal disease patients. Int. Urol.
Nephrol. 33(1): 195-202.
Revicki, D.A., Rentz, A.M., Harnam, N., Thomas,
V.S. & Lanzetta, P. 2010. Reliability
an234d validity of the national eye institute visual function
questionnaire-25 in patients with age-related macular degeneration.
Invest Ophthalmol. Vis. Sci. 51(2):
712-717.
Rizal, A.M., Muhammad, M., Aljunid, S.M., Normalina, M., Faridah Hanom, A., Chuah, K.L., Suzainah, Y., Zainal,
M. & Azman, A.B. 2007. Effectiveness
of cataract surgery with intraoular
lens implantation: A comparative study between extracapsular cataract
extraction and phacoemulsification. Jurnal
Kesihatan Masyarakat 13(1):
32-37.
Sabour-Pickett, S., Loughman, J., Nolan, J.M., Stack, J., Pesudovs,
K., Meagher, K.A. & Beatty, S. 2013. Visual
performance in patients with neovascular
age-related macular degeneration undergoing treatment with intravitreal
ranibizumab. J. Ophthalmol.
2013: 268438.
Sahel, J.A., Bandello, F., Augustin, A.,
Maurel, F., Negrini,
C. & Berdeaux, G.H. 2007. Health-related quality of life and utility in patients with age-related
macular degeneration. Arch. Ophthalmol.
125(7): 945-951.
Sanjay, S., Neo, H.Y., Sangtam, T., Ku, J.Y., Chau, S.Y., Rostihar,
A.K. & Au Eong, K.G. 2009. Survey on the knowledge of age-related macular degeneration and its
risk factors among Singapore residents. Clin. Exp.
Ophthalmol. 37(8): 795-800.
Soubrane,
G., Cruess, A., Lotery,
A., Pauleikhoff, D., Monès,
J., Xu, X., Zlateva, G., Buggage,
R., Conlon, J. & Goss, T.F. 2007. Burden and health
care resource utilization in neovascular
age-related macular degeneration: Findings of a multicountry
study. Arch. Ophthalmol. 125(9):
1249-1254.
Tabachnick,
B.G. & Fidell, L.S. 1996. Using Multivariate Statistics. 3rd ed. New York: Harper Collins.
Taylor, D.J., Hobby, A.E., Binns, A.M. & Crabb, D.P. 2016.
How does age-related macular degeneration affect real-world visual
ability and quality of life? A systematic review.
BMJ Open 6(12): e011504.
WHO. 2014. WHO - Visual
impairment and blindness. Vis Impair Blind
http://www.who.int/mediacentre/factsheets/fs282/en/.
Yuzawa, M., Fujita, K., Tanaka, E. &
Wang, E.C.Y. 2013. Assessing quality of
life in the treatment of patients with age-related macular degeneration:
Clinical research findings and recommendations for clinical practice.
Clin.
Ophthalmol. 7: 1325-1332.
Ziemssen, F., Feltgen, N., Holz, F.G., Guthoff, R., Ringwald, A., Bertelmann,
T., Wiedon, A., Korb,
C. & OCEAN study group. 2017. Demographics of patients receiving
Intravitreal anti- VEGF treatment in real-world practice: Healthcare
research data versus randomized controlled trials. BMC
Ophthalmol. 17(1): 7.
*Corresponding
author; email: sharanjeet@ukm.edu.my