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

Vuong Nguyen , Vincent Daien (1, 2) , Robyn H. Guymer , Ian L. Mcallister , Nigel Morlet , Daniel Barthelmes , Mark C. Gillies

1 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique
2 Service d'Ophtalmologie [Montpellier]

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. \textless80 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.

Mots clés: Humans; Female; Male; Databases; Factual; Aged; 80 and over; Cross-Sectional Studies; Registries; Prognosis; Prospective Studies; Incidence; Visual Acuity; Australia; Angiogenesis Inhibitors; Vascular Endothelial Growth Factor A; Blindness; Wet Macular Degeneration; Intravitreal Injections; neovascular age-related macular degeneration; socio-economic factors

Domaines: Sciences du Vivant [q-bio]

Vuong Nguyen, Vincent Daien, Robyn H. Guymer, Ian L. Mcallister, Nigel Morlet, et al.. 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. Clinical and Experimental Ophthalmology, 2018, 46 (3), pp.266--274. ⟨10.1111/ceo.13038⟩. ⟨hal-02337220⟩