The intraocular implant and visual rehabilitation improve the quality of life of elderly patients with geographic atrophy secondary to age-related macular degeneration

Abstract

Introduction The objective of this prospective study was to evaluate the effects of intraocular macular lens implantation and visual rehabilitation on the quality of life of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods Patients with bilaterally decreased near vision (not better than 0.3 logMAR with the best correction), pseudophakia, were included in the project. The Scharioth macula lens (SML) was implanted into the patients’ better-seeing eye. Intensive visual rehabilitation of the ability to perform nearby activities was performed for 20 consecutive postoperative days. All subjects were examined before and after SML implantation ophthalmologically. The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was administered before and 6 months after surgery. Results Twenty eligible patients with mean age 81 years (63 to 92 years) were included in the project: 7 males and 13 females. Nineteen of them completed the 6-month follow-up. Near uncorrected visual acuity was 1.321 ± 0.208 logMAR before SML implantation and improved to 0.547 ± 0.210 logMAR after 6 months (dz = − 2.846, p < 0.001, BF10 = 3.29E + 07). In the composite score of the NEI VFQ-25, there was an improvement in the general score and the specific domains related to the implantation. Participants reported fewer difficulties in performing near activities (dz = 0.91, p = 0.001, BF10 = 39.718) and upturns in mental health symptoms related to vision (dz = 0.62, p = .014, BF10 = 3.937). Conclusion SML implantation, followed by appropriate rehabilitation, improved near vision and increased the quality of life of visually handicapped patients with AMD in our project.

Advancements in the treatment of geographic atrophy: focus on pegcetacoplan in age-related macular degeneration

“…It encompasses numerous services that help to enhance low vision including prescription eyewear, visual aids like magnifying glasses, and learning skills to better manage everyday activities 22 . A recent study concluded that the implantation of the Scharioth macula lens in the better-seeing eye of GA patients followed by visual rehabilitation enhanced near vision and alleviated mental health signs related to vision 32 . According to another study, visual training in patients with AMD leads to improvements in fixation stability, reading speed, and visual acuity 24 .…”

Geographic atrophy – Signs, symptoms, and quality of life

“…A few studies investigated the effect of visual rehabilitation, Nekolova et al. (2023) showed that implantation of a magnifying add‐on lens implant followed by intensive visual rehabilitation for 20 days had a significant positive effect on performing near activities and upturns in mental health symptoms related to vision. It is unclear if the effect was caused by rehabilitation or implantation of the magnifying lens.…”

Therapies for Geographic Atrophy

“…Training to improve eye movement control has also been shown to increase reading speed in patients with AMD 30 . Rehabilitation techniques utilizing microperimetry and intraocular implants have also shown varying degrees of effectiveness in improving visual outcomes 31,32 . While maximizing patients’ remaining vision is essential for preserving the quality of life, a more robust solution to slow or even halt the inevitable decline of vision from worsening GA is desperately needed.…”