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  • Geographic Atrophy Lesion Locations May Differentially Impact Patient Quality of Life

    Retina/Vitreous

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    Review of: Association of lesion location and functional parameters on vision-related quality of life in geographic atrophy secondary to AMD

    Künzel S, Broadbent E, Möller P, et al. Ophthalmology Retina, in press 2024

    In a small cohort of patients with bilateral geographic atrophy (GA) secondary to advanced dry AMD, investigators found that certain structural and functional features of the disease had greater impact on vision-related quality of life (VRQoL) than others. Awareness of these correlations could help physicians better counsel patients and make VRQoL-conscious treatment decisions.

    Study Design

    This was a single-center, prospective natural-history study involving 82 patients (164 eyes) with bilateral GA due to advanced dry AMD (neovascular AMD cases were excluded) investigating the relationship between structural and functional features of GA and VRQoL. Objective assessments of visual function included BCVA, low-luminance visual acuity, reading acuity, reading speed, and NEI Visual Function Questionnaire-25 scores. Structural assessments included semi-automatic determination of GA size from fundus autofluorescence and infrared reflectance, topographic location of GA using Early Treatment Diabetic Retinopathy Study (ETDRS) grid locations, and subfoveal involvement of GA.

    Outcomes

    The topographic locations with the greatest influence on VRQoL in multivariable regression were the inner lower (distance vision) and inner left (near vision) subfields of the better-seeing eye, with worse disease in these locations correlating with lower VRQoL scores. For patients with non-subfoveal GA, the low-luminance visual acuity of the better eye was the most influential factor across all VRQoL variables.

    Limitations

    This study is limited by its small sample size, which only included patients with functional decline related to bilateral geographic atrophy from dry AMD. Additionally, its survey of low-luminance visual function was limited to an even smaller cohort of patients. Both factors limit the generalizability of the findings.

    Clinical Significance

    The findings correlate specific structural and functional changes due to GA with a patient’s VRQoL, knowledge of which can aid clinician understanding of how disease progression impacts a patient's life.

    Financial Disclosures: Dr. Rebecca Soares discloses no financial relationships.