Associations among comorbidities, visual acuity, and quality of life in patients with age-related macular degeneration and central vision loss

Purpose. To determine relative contributions of reduced vision and medical conditions on health-related quality of life and to determine whether information on medical conditions is needed to interpret vision-related quality of life information.; Patients and methods. One hundred ninety-seven patients enrolled in 10 clinical centers in the Submacular Surgery Pilot Study. Data on visual acuity and quality of life interviews (NEI-VFQ and SF-36) were collected as part of the pilot trials. Information on medical conditions was collected by a chart review. Data were analyzed using linear regression methods.; Results. Patients included in the study were predominantly Caucasian (97%) with median age of 75 years. The most common medical conditions in this population were hypertension, arthritis or rheumatism, heart attack or angina, diabetes, cancer, and hearing problems. Although better eye visual acuity had a dominant effect on NEI-VFQ scores, some subscales were associated with common medical conditions. The presence of arthritis or rheumatism had a significant impact on the dependency subscale (10.7 points lower (SE = 5.3)), diabetes on the distance activities subscale (12.2 points lower (SE = 4.8)), and hypertension on the ocular pain scale (7.6 points higher (SE = 3.2)) after adjustment for better eye visual acuity. Adjustment for presence of medical conditions did not affect differences between treatment arms with respect to NEI-VFQ scores. Adjustment of NEI-VFQ scores for SF-36 physical and mental component summary scale scores yielded as much as 4.3 points change in the difference between treatment arms compared with unadjusted scores. SF-36 physical, but not mental, component summary scale scores were related to 3 of 6 common medical conditions. SF-36 physical and mental component summary scale scores were not sensitive to differences in better eye visual acuity.; Conclusions. Some of the NEI-VFQ subscale scores were influenced by presence of medical conditions. SF-36 physical and mental component summary scale scores may be a better measure of general health status than information on individual medical conditions and should be collected when vision-related quality of life using the NEI-VFQ is an outcome of interest. SF-36 physical and mental component summary scale scores do not measure disability related to central vision loss.