A Systematic Literature Review of the Humanistic Burden Associated with Geographic Atrophy

OBJECTIVES: The objective of the present review is to provide a comprehensive analysis of the humanistic burden associated with geographic atrophy (GA), the advanced stage of dry age-related macular degeneration that leads to vision loss.

METHODS: A comprehensive literature search was performed across Medline and Embase databases. Eligibility criteria were predefined, and studies published in English between January 2013 and June 2023 were included in the analysis.

RESULTS: Our systematic literature review identified 22 unique studies, conducted primarily in North America and Europe, with sample size ranging from 8 to 259 participants. The mean age for included participants ranged from 64 to 82 years.

In these studies, seven different disease-specific scales were used to measure health-related quality of life (HRQoL). Among these scales, the NEI-VFQ scale was the most frequently used, appearing in 55% of the studies, followed by the Functional Reading Independence (FRI) Index (9% of studies). The key symptoms and concepts assessed were near activities, distance activities, general vision, near vision, dependency, mental health, social functioning, reading speed, functional reading independence, anxiety/depression, fear, difficulty driving, and impaired ability to recognise faces.

In two comparative studies, it was found that those with GA had poorer vision-related functioning and lower HRQoL than patients without GA. Patients in the GA group had significantly lower NEI-VFQ-25 composite scores compared to those in the non-GA group (p<0.001). Furthermore, patients with GA had significantly lower scores in NEI-VFQ-25 subscales related to near activities, distance activities, social functioning, and mental health compared to patients without GA (p<0.001).

CONCLUSIONS: These findings underscore the significant impact of GA on patients' visual functioning and HRQoL. The insights gained from this literature review provide a valuable foundation for further research and contribute to the understanding of the humanistic burden associated with GA.