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

Neovascular age-related macular degeneration (nAMD) is the advanced and irreversible stage of AMD, the leading cause of severe vision loss in older adults. While anti-vascular endothelial growth factor (anti-VEGF) injections have been shown to preserve or improve vision quality in eyes with nAMD, 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 nAMD 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 socio-economic status, treatment regimen, other comorbidities, provider-level barriers, and system-level barriers. We provide an overview of the major barriers to nAMD care that have been reported, as well as gaps in research that need to be investigated further.