Acta Ophthalmol. 2026 Nov;104(7):e803-e809. doi: 10.1111/aos.70150.
Summary
nAMD Vision-related quality of life stable with unilateral disease, but decreased without recovery in 2nd eye — FASTBAT, 424 patients
Abstract
Purpose: The study evaluated the long-term effect on vision-related quality-of-life (VRQoL) of routinely treated neovascular age-related macular degeneration (nAMD) in first and second eyes.
Methods: The FASBAT (Observing Fibrosis, macular Atrophy and Subretinal highly reflective material Before and After Treatment with anti-VEGF treatment) study followed individuals with new unilateral nAMD (first eye) undergoing routine treatment for up to 4.5 years. Visual acuity (VA) was measured as part of routine care and VRQoL was assessed using the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25).
Results: Of the 424 participants, 307 had only the first eye affected by nAMD (mean age = 76.5, SD = 8.4 years). The mean VA was 58.1 (SD = 15.5) and 79.4 (SD = 5.6) letters at baseline, and 58.4 (SD = 20.9)/78.5 (SD = 7.8) letters at 36-months in the affected and unaffected eyes, respectively. The mean composite NEI-VFQ-25 score was 87.1 (SD = 11.9) at baseline and 85.2 (SD = 13.5) at 36-months. One hundred and seventeen participants (mean age = 77.6, SD = 7.3 years) developed second eye nAMD, with a mean of 18.9 (SD = 10.2) months following the first eye. Mean VA in first and second eye was 56.3 (SD = 19.3)/74.1 (SD = 9.9) letters at the time of second eye development, and 51.1 (SD = 22.5)/73.6 (SD = 8.9) letters after 24-months. Mean composite NEI-VFQ-25 score was 81.4 (SD = 14.6) and 79.1 (SD = 17.2) at these time points.
Conclusions: Long-term VRQoL remains stable in unilateral treated nAMD. However, a clinically meaningful reduction in VRQoL occurs following development and treatment in the second eye which does not recover. It is important to offer appropriate support when the first and then second eye develop nAMD.
