Article Text

Download PDFPDF

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review
  1. Deanna J Taylor,
  2. Angharad E Hobby,
  3. Alison M Binns,
  4. David P Crabb
  1. Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
  1. Correspondence to Professor David P Crabb; David.Crabb.1{at}


Objectives To review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature.

Design Systematic review.

Methods A systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT).

Results From 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%.

Conclusions There are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD.

  • quality of life
  • visual disability
  • age-related macular degeneration
  • systematic review

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter Follow the Crabb Lab at @crabblab

  • Contributors All the authors contributed to study design. DJT and AEH screened abstracts and full-text articles for inclusion. DJT appraised study quality. Any disagreements or uncertainties during the screening and quality appraisal process were referred to DPC. DJT drafted the manuscript, which was reviewed, edited and approved by DPC and AMB.

  • Funding This work was supported by an unrestricted investigator initiated research grant from Roche Products, UK.

  • Competing interests None declared.

  • Patient consent No.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.