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

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. (c) 2023 Elsevier Inc. All rights reserved.