Vision-related quality of life: 12-month aflibercept treatment in patients with treatment-resistant neovascular age-related macular degeneration

Meidong Zhu, Wijeyanthy Wijeyakumar, Adil R. Syed, Nichole Joachim, Thomas Hong, Geoffrey K. Broadhead, Haitao Li, Kehui Luo, Andrew Chang*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    5 Citations (Scopus)


    Purpose: To assess changes in vision-related quality of life (VR-QoL) among patients with treatment-resistant neovascular age-related macular degeneration (nAMD) following intravitreal aflibercept treatment over 48 weeks. Methods: We conducted a prospective study in which 49 patients with nAMD resistant to anti-vascular endothelial growth factor therapy were switched to intravitreal aflibercept. Patients were treated with three loading doses every 4 weeks followed by injections every 8 weeks, for a total of 48 weeks. Ophthalmic examinations performed at each visit included best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurement. The National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) was used to assess VR-QoL at baseline and weeks 24 and 48. Changes in NEI VFQ-25 composite and subscale scores were analyzed using paired t tests. The relationship between the change in VR-QoL and changes in BCVA and CMT, and the impact of the better-seeing eye (BSE, defined as the eye reading the greater number of letters at baseline) vs. the worse-seeing eye (WSE, the fellow eye to the BSE) were assessed. Results: Mean NEI VFQ-25 composite scores improved significantly at weeks 24 and 48 compared to baseline (4.5 ± 9.2 and 4.4 ± 11.8, respectively, all p < 0.01). Among subscales, general vision and near and distance activities showed significant improvements at weeks 24 and 48 (all p < 0.05). Improvement in the NEI VFQ-25 composite score was significantly associated with increased BCVA at week 48 (β coefficient = 0.43, p = 0.029), but not with change in CMT (β coefficient = −0.007, p = 0.631). There was no association between VR-QoL changes and BSE or WSE. Conclusion: Despite previous anti-VEGF treatment in this cohort, overall VR-QoL improved following aflibercept therapy over 48 weeks. This improvement was related to improved vision in treatment eyes regardless of whether they were the BSE or WSE.

    Original languageEnglish
    Pages (from-to)475-484
    Number of pages10
    JournalGraefe's Archive for Clinical and Experimental Ophthalmology
    Issue number3
    Publication statusPublished - Mar 2017


    • vision-related quality of life (VR-QoL)
    • neovascular age-related macular degeneration (nAMD)
    • intravitreal aflibercept
    • anti-vascular endothelial growth factor (anti-VEGF)
    • treatment resistant
    • prospective clinical trial

    Fingerprint Dive into the research topics of 'Vision-related quality of life: 12-month aflibercept treatment in patients with treatment-resistant neovascular age-related macular degeneration'. Together they form a unique fingerprint.

    Cite this