Self-efficacy in patients with neovascular age-related macular degeneration in anti-vascular endothelial growth factor therapy

Purpose We aimed to characterize general self-efficacy (GSE) and its associated factors in patients with nAMD receiving anti-vascular endothelial growth factor therapy Design Cross-sectional study. Participants 251 patients with nAMD receiving anti-VEGF therapy at a tax-funded hospital setting in Denmark between May and July 2025. Methods Participants completed the General Self-Efficacy Scale and the NEI-VFQ-25, alongside a study-specific demographic questionnaire. Clinical data including best-corrected visual acuity (BCVA) and injection history were obtained from medical records. Multivariable linear regression with bootstrapping was performed to evaluate associations between GSE and demographic, clinical, and vision-related quality of life (VRQoL) measures. Results Among 251 participants (59.8% women, median age 80.3 years [IQR 75.8–85.4]), the median GSE score was 33.0 (IQR 29.0–38.0). Higher GSE was associated with better BCVA in the better-seeing eye (β, -0.58 per 0.1 logMAR increment [95% CI -0.91 to -0.26]; P < 0.001) and higher VRQoL (β, 2.10 per 10-point increment [95% CI 1.60 to 2.60]; P < 0.001), with the strongest correlations in domains reflecting autonomy (Dependency ρ=0.53, Role Difficulties ρ=0.48). No associations were found between GSE and treatment duration, injection frequency, or laterality. Conclusions Among patients with nAMD in treatment with anti-VEGF, self-efficacy was closely tied to functional autonomy and visual function, but showed no statistically significant association with measures of treatment burden. These findings characterize the psychological profile of patients who successfully maintain long-term therapy, and suggest that functional independence may be a clinically relevant consideration in this population.