Table 2 Participants’ reasoning regarding their treatment preferences, with example quotations

Preserved vision for…

O1: 5 years (no treatment, baseline)

O2: 6 years (20% slowing)

O3: 6.5 years (30% slowing)

O4: 5.5 years (10% slowing)

Relatively small magnitude of efficacy

1. “[There’s] not much difference between 5 years, 5 and a half, or 6 and a half. So I would choose no treatment or less injections.” (P5 – O1 = O2)

2. “If my fellow eye was affected, I would be more interested. I am 85 years old, if I have 2 more years I will be satisfied. So 1.5 years is not long enough. If you said 10 years it would be different.” (P10 – O4)

Any preservation of visual function is beneficial

3. “No injection option is out of question… Even if six months [more vision] is not long, it is still better. I know there’s a risk of wet [AMD], but longer vision is better.” (P29 – O3)

4. “I know six months is precious. But it’s not very long. I’d still go for Option 3… Yes, I’d try to get the maximum benefit.” (P26 – O3)

Frequency of hospital visit and injection:

O1: None (no treatment, baseline)

O2: 6 times per year (once every two months)

O3: 12 times per year (monthly)

O4: 4 times per year (every three months)

Frequent injections are preferable

5. “I would like to have more frequent injections, ideally four weekly [ie once a month, Option 3], because I feel safer under close monitoring.” (P8 – O3)

Frequent injections are burdensome

6. “Twelve injections that’s a lot. But it depends. Less injections is better. Twelve is a lot - I might even forget.” (P23 – O4)

7. “If I was to sell this to my mother… and the amount of effort she would have to make to come to hospital. And given her life expectancy. She would go for minimum injections. Because of my mum’s age and health.” (P25 – son speaking on behalf of mother – O1)

Time spent at clinic:

O1: None

O2: Up to two hours

O3: Up to two hours

O4: Up to two hours

Time at the eye clinic is burdensome

8. “Two hours is a long time. Not many people will be happy.” (P23 – O4)

Risk of developing neovascular AMD within a year of starting treatment

O1: 1 in 50 (no treatment, baseline)

O2: 1 in 20

O3: 1 in 10

O4: 1 in 50

Risk of wet AMD as drawback to more frequent, effective treatment

9. “It [concern about wet AMD] is my biggest thing. Because I’ve been told that’s worse than the dry one. They’re trying to stop the dry one developing into the wet one… the one in 50 chance of not getting it [in Option 4], that’s what sways me.” (P13 – O4)

10. [Discussing Option 3] “One in 10 chances of AMD, then I will have to have injection for wet. I think it’s not an option. I still don’t know.” (P28 – O2)

11. [Discussing Option 2] “The risk of wet AMD is off-putting as well. If you are going to get it anyway, like 1 in 20.” (P25 – O1)

Risk of wet AMD not affecting decision-making

12. “I’m not concerned about the risk of wet AMD in particular.” (P7 – O2 = O3)

13. [Discussing Option 3] “He has a one in 10 chance of developing wet AMD. That’s interesting, isn’t it? That’s quite high, one in 10. So I have to make the same assumption that that [wet AMD] isn’t a disaster. Because it’s quite likely”. (P26 – O3)