Wet AMD Burden Study (WABS)
Research type
Research Study
Full title
Influence of treatment burden on quality of life of patients on anti-VEGF treatment pathway for neovascular age related macular degeneration (Wet AMD)
IRAS ID
361272
Contact name
Ling Zhi Heng
Contact email
Sponsor organisation
Moorfields eye hospital nhs trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Neovascular age-related macular degeneration (nAMD), otherwise termed wet AMD, is the leading cause of sight loss in adults 50 years and older in developed nations, if left untreated. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is a successful treatment to stabilize visual acuity in the majority of the patients. The efficacy and safety of all available intravitreal antiVEGF therapies in nAMD are well established. However, the treatment and monitoring protocols are intense, with loading dose of 3 monthly treatment necessitating at least four visits to hospital a year with or without intravitreal injections, usually resulting in years of healthcare burden both financially and the provision of treatment support.
The vision related quality of life may vary between treated individuals. Although it can be assumed that this may be related to the visual acuity, there are many other factors that may influence the outcome. The validated NEI-VFQ-25 questionnaire only covers vision related questions while the EQ-5D-5L vision bolt-on envelopes both general health and vision.
There are several factors that determine the quality of life of patients with wet AMD after being on the anti-VEGF treatment pathway for 2 years. Firstly, while some patients may indeed retain driving vision, others may have poorer visual outcome. Whilst baseline visual acuity is a strong predictor of final visual outcome, other factors other than visual outcome may include challenges with daily living. Two people with the same visual acuity at 2-years may have different needs for their visual acuity and quality of life. In addition, the frequency of hospital visits and numbers and types of injections may impact quality of life. For example, the average number of injections across 2 years for the different antiVEGF agents differ; ranibizumab- 16 injections, aflibercept 2 mg -12.8 injections, high dose (8mg ) aflibercept- 9.7injections and faricimab is10 injections. The treatment burden also varies between individuals. Their reliance on transport may be other factors. Some patients may need to travel considerable distance for hospital appointments. Their treatment satisfaction or anxiety associated with eye injections may also influence their quality of life. Other factors may be their general health and the need to attend other hospital appointments.
Many patients require a caregiver to accompany them to the hospital visits increasing burden not only on patients but also caregivers. A primary caregiver was defined as “any person who, without being a professional or belonging to a social support network, and in some way, is directly implicated in the patient’s eye care or is directly affected by the patient’s health problem”. The role of caregiver burden on patient’s quality of life is also unknown.
In this prospective study, we will use validated questionnaires for patients to determine the impact of the wet AMD injection on their quality of life.REC name
South Central - Oxford A Research Ethics Committee
REC reference
25/SC/0341
Date of REC Opinion
14 Nov 2025
REC opinion
Further Information Favourable Opinion