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Clinical and social characteristics associated with reduced visual acuity at presentation in Australian patients with neovascular age‐related macular degeneration: a prospective study from a long‐term observational data set. The Fight Retinal Blindness! Project
Author(s) -
Nguyen Vuong,
Daien Vincent,
Guymer Robyn H,
McAllister Ian L,
Morlet Nigel,
Barthelmes Daniel,
Gillies Mark C
Publication year - 2018
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.13038
Subject(s) - medicine , observational study , macular degeneration , visual acuity , confidence interval , odds ratio , ethnic group , demography , prospective cohort study , ophthalmology , pediatrics , surgery , sociology , anthropology
Abstract Importance Identifying variables that influence presenting visual acuity (VA) in patients with neovascular age‐related macular degeneration (nAMD) is important because it is a strong predictor of long‐term outcomes. Background To assess the clinical and social characteristics associated with low presenting VA in nAMD patients. Design The present study is a cross‐sectional analysis from a prospective, observational database. Participants We identified 3242 treatment‐naïve patients from 54 Australian practices in the Fight Retinal Blindness! registry. Methods Age, gender, ethnicity and VA were recorded at the baseline visit. Socio‐economic status was determined using the Australian Bureau of Statistics socio‐economic indexes for areas. Main Outcome Measures Association between clinical and socio‐economic characteristics with presenting VA was identified. Results Poor VA (≤35 letters) in the presenting eye was associated with older age (adjusted odds ratio [AOR]: 1.33 for patients aged ≥80 years vs . <80 years [95% confidence interval, CI: 1.04, 1.71]), treatment at a public practice (AOR: 1.91 for public vs . private practices [95% CI: 1.46, 2.50]) and intermediate (36–69 letters) VA in the fellow eye (AOR: 0.67 [95% CI: 0.47, 0.95] and 0.64 [95% CI: 0.48, 0.85] for poor [≤35 letters] and good [≥70 letters] VA vs . intermediate VA in the fellow eye). Gender, ethnicity and socio‐economic status were not independently associated with VA at presentation. Conclusions and Relevance Poor presenting vision is detrimental to the long‐term outcomes of nAMD. Poor presentation of nAMD in Australia may not be related to socio‐economic circumstances, but due to systems of care. Further research is warranted to determine why patients at public practices present with worse vision compared with private practices in Australia.