Abstract:
Purpose: To examine the prevalence and predictors of patient awareness of their disease in adults with age-related macular degeneration (AMD). Methods: This study analyzed 5553 adults 40 years or older in the 2005-2008 National Health and Nutrition Examination Survey who underwent retinal imaging. AMD was determined based on retinal images. Patient awareness of their AMD was assessed by a self-reported AMD diagnosis. Multivariable logistic regression models were constructed to examine the association of patient awareness of their AMD with sociodemographic characteristics and specific AMD lesion types on retinal imaging. Results: AMD was identified in 425 of the adults surveyed (6.5%) (95% confidence interval [CI], 5.5%-7.5%), including 87.7% (95% CI, 82.9%-92.5%) with early AMD and 12.3% (95% CI, 7.5%-17.1%) with late AMD. Among adults with either type of AMD on retinal imaging, 17.5% (95% CI, 13.1%-22.0%) were aware of their disease, which included 11.6% (95% CI, 8.4%-14.9%) with early AMD and 59.2% (95% CI, 43.1%-75.3%) with late AMD (P < .0001). In the same group, those aged 60 years or older (odds ratio [OR], 33.46; 95% CI, 7.67-146.03) and with a best-corrected visual acuity of 20/40 or worse (OR, 4.63; 95% CI, 2.95-7.26) had higher awareness of their AMD diagnosis, whereas Hispanic (OR, 0.28; 95% CI, 0.09-0.88) vs White adults and those who did not speak English at home (OR, 0.05; 95% CI, 0.01-0.41) had lower awareness of their diagnosis. Conclusions: Fewer than 1 in 5 adults with AMD were aware of their personal diagnosis, including fewer than 3 in 5 adults with late AMD. Older adults and those with worse vision were more likely to know they have AMD, whereas Hispanic adults and those who did not speak English at home were less likely. Efforts to increase patients\' awareness of their AMD may improve rates of follow-up and prevent vision loss.
摘要:
目的:研究年龄相关性黄斑变性(AMD)成人患者对其疾病的认识的患病率和预测因素。方法:这项研究分析了2005-2008年全国健康和营养检查调查中5553名40岁或以上的成年人进行了视网膜成像。基于视网膜图像确定AMD。通过自我报告的AMD诊断评估患者对其AMD的认识。建立多变量逻辑回归模型,以检查患者对AMD的认识与视网膜影像学上的社会人口统计学特征和特定AMD病变类型之间的关系。结果:在接受调查的425名成年人中发现了AMD(6.5%)(95%置信区间[CI],5.5%-7.5%),包括早期AMD的87.7%(95%CI,82.9%-92.5%)和晚期AMD的12.3%(95%CI,7.5%-17.1%)。在视网膜成像上患有两种AMD的成年人中,17.5%(95%CI,13.1%-22.0%)知道他们的疾病,其中早期AMD为11.6%(95%CI,8.4%-14.9%),晚期AMD为59.2%(95%CI,43.1%-75.3%)(P<0.0001)。在同一组中,60岁或以上的人(赔率比[OR],33.46;95%CI,7.67-146.03),最佳矫正视力为20/40或更差(OR,4.63;95%CI,2.95-7.26)对他们的AMD诊断有更高的认识,而西班牙裔(或,0.28;95%CI,0.09-0.88)与白人成年人和在家不会说英语的人(OR,0.05;95%CI,0.01-0.41)对其诊断的知晓率较低。结论:少于1/5的AMD成年人知道他们的个人诊断,包括少于3/5的晚期AMD成人。老年人和视力较差的人更有可能知道自己患有AMD,而西班牙裔成年人和在家不会说英语的人的可能性较小。努力提高患者对AMD的认识可能会提高随访率并防止视力丧失。