Review Identifies Barriers to Neovascular Age-Related Macular Degeneration Treatment

Travel, psychological factors, and financial burden on patients and their caregivers were the most common barriers to treatment for neovascular age-related macular degeneration, according to a review article published online ahead of print in Survey of Ophthalmology.

“Neovascular age-related macular degeneration is the advanced and irreversible stage of age-related macular degeneration, the leading cause of severe vision loss in older adults,” wrote corresponding author Jay Chhablani, MD, of the University of Pittsburgh School of Medicine Department of Ophthalmology, Pittsburgh, Pennsylvania, and study coauthors. “While anti-vascular endothelial growth factor (VEGF) injections have been shown to preserve or improve vision quality in eyes with neovascular age-related macular degeneration, the treatment regimen can be demanding of patients and caregivers, leading to lower rates of adherence.”

The study is the first to provide a comprehensive overview of the literature assessing obstacles to care for neovascular age-related macular degeneration, the authors reported. The 18 papers included in the review took into account the perspective of patients, caretakers, and physicians.

In all, researchers identified a handful of major barrier-to-care categories that spanned the individual, provider, and system levels. The seven categories were travel burden, psychological barriers, financial burden and socioeconomic status, treatment regimen, other comorbidities, provider-level barriers, and system-level barriers.

“Despite the vision-preserving capabilities of anti-VEGF therapy, its invasive and time-intensive nature can lead to reduced patient adherence to neovascular age-related macular degeneration treatment and worse visual outcomes in the long-term,” researchers wrote. “This creates a need for ways to improve access to care, as well as alternative treatment modalities.”

Reference

Choi A, Nawash BS, Du K, Ong J, Chhablani J. Barriers to care in neovascular age-related macular degeneration: Current understanding, developments, and future directions. Surv Ophthalmol. Published online September 14, 2023. doi:10.1016/j.survophthal.2023.09.001