Visual Functioning and Progression from Intermediate Age-Related Macular Degeneration (AMD) to Advanced AMD

Area of Science:

• Ophthalmology
• Vision Science
• Clinical Research

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Intermediate AMD (iAMD) can progress to advanced stages, including geographic atrophy (GA) and neovascular (NV) AMD.
• Predictive markers for iAMD progression are crucial for timely intervention.

Purpose of the Study:

• To determine if the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) can predict the progression of iAMD to advanced non-neovascular (NNV) or neovascular (NV) forms.
• To assess the predictive value of specific NEI VFQ-25 subscales for AMD progression.

Main Methods:

• A cohort of 380 patients with iAMD (aged 55-99 years) was followed for a median of 32 months.
• Progression to advanced AMD was determined by multimodal imaging review.
• Baseline NEI VFQ-25 scores and visual acuity were analyzed using Cox proportional hazards models and Kaplan-Meier analysis.

Main Results:

• 34.5% of participants progressed to advanced AMD.
• Worse baseline visual acuity in both eyes predicted progression.
• Lower NEI VFQ-25 general vision and distance activities scores at baseline predicted progression to advanced AMD.
• The general vision score remained a significant independent predictor in multivariable analysis.

Conclusions:

• Lower NEI VFQ-25 general vision subscale scores independently predict progression to advanced AMD.
• The NEI VFQ-25 is a valuable tool for identifying iAMD patients at higher risk of progression.
• These findings can aid in patient monitoring and treatment strategies for AMD.