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Monica Varano; Current Management and Barriers to Treatment for Wet Age-related Macular Degeneration: Perspectives From Patients and Caregivers. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3876.
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Wet age-related macular degeneration (wAMD), a leading cause of vision loss in older people in the Western world, can be effectively treated with anti-vascular endothelial growth factor (VEGF) injections. A global survey of patients and caregivers was conducted to evaluate the current management of wAMD and identify perceived barriers to treatment.
Patients and caregivers of patients diagnosed with wAMD, who currently or previously had received intravitreal injections to treat their wAMD, were surveyed. The survey was conducted in 9 countries (Australia, Brazil, Canada, France, Germany, Italy, Japan, Spain, and United Kingdom).
910 patients and 890 caregivers were surveyed. About half (55%) of patients had wAMD in 1 eye and 64% had been receiving anti-VEGF injections for >1 year. Most caregivers surveyed were a child or grandchild of the patient. Most (73%) patients visited a healthcare professional within 1 month of first noticing a change in vision. For those who delayed visiting a healthcare professional, the main reasons were the belief that the symptoms would resolve (41%) and the assumption that it was part of getting older (20%). Following diagnosis, about half (54%) of patients began treatment immediately and a further 37% had an appointment scheduled within 1-3 weeks of diagnosis. Half (52%) of patients reported a temporary improvement or stabilization in vision as a result of their current treatment and 22% reported a return to pre-diagnosis vision or their vision was still improving. Of the 16% of patients who reported having missed a wAMD appointment, the main reasons reported were that their caregiver was unable to take them (26%) and fear of injections (21%). Most patients and caregivers reported a number of obstacles in managing wAMD, including the treatment itself (35% and 39%, respectively), treatment costs (28% and 29%, respectively), and finding the right treatment options (27% and 31%, respectively).
While most patients seek medical assistance promptly for a change in vision, about a quarter of them do not, highlighting a lack of awareness surrounding eye health and the impact of a delayed diagnosis. Most patients and caregivers believe there are a number of obstacles in managing wAMD. Key barriers identified were the treatment itself, finding the right treatment options, and treatment costs.
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