The Impact and Burden of Visual Impairment in Patients With Dry Age-Related Macular Degeneration Relative to Older Adults Without Major Eye Conditions: A Qualitative Interview Study

OBJECTIVES: Dry age-related macular degeneration (AMD) leads to progressive vision loss. This qualitative study assessed functional impairment and humanistic burden associated with dry AMD vision loss, for patients relative to older adults without dry AMD (controls).

METHODS: Semi-structured telephone interviews were conducted (March 2021–June 2023) in patients with dry AMD aged ≥50 years and controls similar in age, sex, and comorbidities as patients, to understand impairment in daily activities, overall and mental health status, and quality of life (QoL). De-identified transcripts were analyzed and results descriptively summarized.

RESULTS: Interviews were conducted in 30 patients with dry AMD (21 mild, 8 moderate, 1 severe visual impairment, based on best-corrected visual acuity [BCVA]) and 20 controls. Mean (standard deviation [SD]) age was 65.1 [7.8] years for patients and 63.4 (8.0) for controls; 63.3% of patients and 65.0% of controls were female. Most patients (n=17, 56.7%) reported at least moderate problems performing usual activities in the last month relative to 15.0% (n=3) of controls. Patients reported a mean (SD) of 4.5 (2.0) activities affected by dry AMD symptoms, while controls reported 2.1 (2.4) activities affected by their vision. Patients tended to report impairment in activities identified as most important to maintain (reading and driving). Reading (n=27, 90.0%) and shopping (n=22, 73.3%) were patients’ most commonly affected activities while most controls reported reading (n=12, 60.0%) and shopping (n=17, 85.0%) were unaffected. Most (n=18, 60.0%) patients and 20.0% (n=4) of controls reported general QoL as either “good and bad parts about equal” or “pretty bad”. Feeling at least “moderately” bothered by emotional problems (e.g., anxious) was reported for 43.3% (n=13) of patients and 30.0% (n=6) of controls.

CONCLUSIONS: Patients with dry AMD had greater functional impairment due to vision loss, and worse QoL and emotional well-being, relative to similar aged adults without dry AMD.