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, Robyn H Guymer, Ian L McAllister, Nigel Morlet, Daniel Barthelmes, Mark C Gillies

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Abstract

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. <80 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.

Original languageEnglish
Pages (from-to)266-274
JournalClinical & Experimental Ophthalmology
Volume46
Issue number3
DOIs
Publication statusPublished - Apr 2018

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Macular Degeneration
Blindness
Visual Acuity
Prospective Studies
Economics
Private Practice
Odds Ratio
Sociological Factors
Datasets
Registries
Cross-Sectional Studies
Databases
Confidence Intervals
Therapeutics

Cite this

@article{7473a8b1070d4144bcd32d29d19ff554,
title = "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",
abstract = "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-na{\"i}ve 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. <80 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.",
author = "Vuong Nguyen and Vincent Daien and Guymer, {Robyn H} and McAllister, {Ian L} and Nigel Morlet and Daniel Barthelmes and Gillies, {Mark C}",
note = "{\circledC} 2017 Royal Australian and New Zealand College of Ophthalmologists.",
year = "2018",
month = "4",
doi = "10.1111/ceo.13038",
language = "English",
volume = "46",
pages = "266--274",
journal = "Clinical & Experimental Ophthalmology",
issn = "1442-6404",
publisher = "John Wiley & Sons",
number = "3",

}

TY - JOUR

T1 - Clinical and social characteristics associated with reduced visual acuity at presentation in Australian patients with neovascular age-related macular degeneration

T2 - a prospective study from a long-term observational data set. The Fight Retinal Blindness! Project

AU - Nguyen, Vuong

AU - Daien, Vincent

AU - Guymer, Robyn H

AU - McAllister, Ian L

AU - Morlet, Nigel

AU - Barthelmes, Daniel

AU - Gillies, Mark C

N1 - © 2017 Royal Australian and New Zealand College of Ophthalmologists.

PY - 2018/4

Y1 - 2018/4

N2 - 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. <80 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.

AB - 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. <80 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.

U2 - 10.1111/ceo.13038

DO - 10.1111/ceo.13038

M3 - Article

VL - 46

SP - 266

EP - 274

JO - Clinical & Experimental Ophthalmology

JF - Clinical & Experimental Ophthalmology

SN - 1442-6404

IS - 3

ER -