The management of neovascular age-related macular degeneration: A systematic literature review of patient-reported outcomes, patient mental health and caregiver burden.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101468102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-3768 (Electronic) Linking ISSN: 1755375X NLM ISO Abbreviation: Acta Ophthalmol Subsets: MEDLINE

Publication: Oxford, UK : Wiley-Blackwell
Original Publication: Oxford, UK ; Malden, MA : Blackwell Munksgaard

Macular Degeneration*/drug therapy ; Wet Macular Degeneration*/diagnosis ; Wet Macular Degeneration*/drug therapy; Humans ; Ranibizumab ; Angiogenesis Inhibitors/therapeutic use ; Vascular Endothelial Growth Factor A ; Quality of Life ; Caregiver Burden ; Mental Health ; Visual Acuity ; Patient Reported Outcome Measures ; Intravitreal Injections ; Treatment Outcome

Purpose: The aim of this systematic literature review was to describe patient-reported outcomes, mental health and caregiver burden in patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (VEGF) agents in routine clinical practice.
Methods: Electronic searches were conducted in Embase and MEDLINE according to pre-defined criteria.
Results: Of 856 records identified, 63 met inclusion criteria. Depression or depressive symptoms were reported in up to 42% of patients with nAMD. Of 25/63 (40%) studies evaluating quality of life (QoL) and using various tools, eight studies reported composite National Eye Institute Visual Functioning Questionnaire scores following anti-VEGF treatment. Of these, seven reported a statistically significant improvement at the earliest time point measured (Month 3-12) and approximately 50% reported sustained QoL benefits at 12 months. In studies comparing the attributed or different regimens, the most important factor from the patient's perspective was the likelihood that a particular regimen would maintain vision. There was a preference towards treat and extend, which was associated with a perceived reduction in patient and caregiver burden, compared to fixed dosing.
Conclusions: A coordinated holistic approach to patient care is key to optimizing patient well-being as well as visual outcomes. Further research regarding the patient-reported impact of nAMD management outside the trial setting (particularly international longitudinal studies) is warranted. Standardization of QoL studies would assist in establishing whether sustained QoL improvement, rather than prevention of QoL decline, should be a realistic expectation of treatment of nAMD in the longer term.
(© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

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Bayer Consumer Care AG

Keywords: intravitreal injections; mental health; neovascular age-related macular degeneration; patient care; quality of life

ZL1R02VT79 (Ranibizumab)
0 (Angiogenesis Inhibitors)
0 (Vascular Endothelial Growth Factor A)

Date Created: 20220705 Date Completed: 20230124 Latest Revision: 20230412

20240105

PMC10084380

10.1111/aos.15201

35790079