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Eye (2015) 29, 15611569 2015 Macmillan Publishers Limited All rights reserved 0950-222X/15
http://www.nature.com/eye
Web End =www.nature.com/eye
C McCloud1 and S Lake2
Understanding the patients lived experience of neovascular age-related macular degeneration: a qualitative study
CLINICALSTUDY
Abstract
Purpose In industrialised populations age-related macular degeneration (ARMD) is the leading cause of visual disability of the elderly. Successful new treatment with anti-endothelial growth factors for neovascular-classied ARMD has led to a divergence in treatment and experiences of people ARMD. This study aimed to understand the participants experience of neovascular ARMD, including ongoing treatment with anti-vascular endothelial growth factor. Methods Twenty-ve participants from one clinical site were qualitatively interviewed to elicit their experiences of treatment for neovascular ARMD.
Results Two major themes were identied.
A life negotiated by neovascular ARMD captures the participants experience of living with the condition and treatment regime for neovascular ARMD. The second major theme: Uncertainty displayed their appraisal of life, treatment and their perceived future. Conclusions Anxieties concerning the injections, new limitations to lifestyles, and an uncertain future all emerged from the data analysis. However, thankfulness for the treatment, the importance of familiar patterns in treatments and recovery and a guarded optimism also emerged. Knowledge of the experiences, anxieties and concerns of this patient population can be used to inform clinical practice and lead to patient-centred care. Eye (2015) 29, 15611569; doi:http://dx.doi.org/10.1038/eye.2015.167
Web End =10.1038/eye.2015.167 ; published online 18 September 2015
Introduction
In industrialised nations age-related macular degeneration (ARMD) is widely cited as the
dominant cause of vision impairment or blindness in 50% of legally blind older adults.1,2
The Australian incidence of ARMD is consistent with that reported internationally3,4 and has the
congruent nomenclature of ARMD, broadly divided into either geographic ARMD, dry or neovascular ARMD, also known as wet ARMD. In the past, geographic ARMD was considered largely untreatable,5,6 while
neovascular ARMD treatment had demonstrated very limited success. The distinction between the two classications of ARMD is relevant for prognostic purposes, including expected disease progression and potential visual disability. Recently, an increasing divergence between the two classications has become evident, resulting from the development of anti-vascular endothelial growth factors (anti-VEGF) as a successful treatment for neovascular ARMD710
in comparison with a continuing lack of successful treatment for geographic ARMD.11
This divergence is not...