Barriers to care in neovascular age-related macular degeneration: Current understanding, developments, and future directions

• Published in: Survey of ophthalmology Vol. 69; no. 1; pp. 160 - 164
• Main Authors: Choi, Alison, Nawash, Baraa S, Du, Katherine, Ong, Joshua, Chhablani, Jay
• Format: Journal Article
• Language: English
• Published: United States 01-01-2024
• Subjects: Aged; Angiogenesis Inhibitors - therapeutic use; Health Services Accessibility; Humans; Intravitreal Injections; Macular Degeneration - drug therapy; Ranibizumab - therapeutic use; Treatment Outcome; Vascular Endothelial Growth Factor A; Visual Acuity; Wet Macular Degeneration - drug therapy; Treatment outcomes; Social determinants of health; Visual acuity; Barriers to care; Anti-vascular endothelial growth factor; Neovascular age-related macular degeneration
• ISSN: 0039-6257; 1879-3304; 1879-3304
• DOI: 10.1016/j.survophthal.2023.09.001

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. While anti-vascular endothelial growth factor 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. Therefore, it is crucial that disparities and obstacles in neovascular age-related macular degeneration care are identified to improve access to treatment. Review of the current literature revealed 7 major categories of barriers: travel burden, psychological barriers, financial burden and socioeconomic status, treatment regimen, other comorbidities, provider-level barriers, and system-level barriers. We provide an overview of the major barriers to neovascular age-related macular degeneration care that have been reported, as well as gaps in research that need to be investigated further.