Controversies and Disparities in the Management of Age-Related Macular Degeneration

Semin Ophthalmol. 2023 Feb;38(2):134-142. doi: 10.1080/08820538.2022.2152705. Epub 2023 Jan 5.

Abstract

Age-related macular degeneration is a leading cause of blindness in patients aged 50 years and older. Prior to the 21st century, there were no effective treatments for this devastating disease. However, the last 20 years have heralded the development of treatments for both the nonexudative and exudative forms. The invention of AREDS vitamin supplements and anti-VEGF therapies forever changed the treatment of dry and wet age-related macular degeneration, respectively. The rapid adoption and expansion of these vision preserving treatments has created controversy regarding their cost, burden of administration, development, and use of new technologies, genetic considerations, and observed societal disparities. Many of these controversies and disparities persist today and will require further research to resolve.

Keywords: Age-related macular degeneration; gene therapy; optical coherence tomography; port delivery system; racial and economic disparities; vascular endothelial growth factor.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use
  • Blindness
  • Humans
  • Intravitreal Injections
  • Middle Aged
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A*
  • Wet Macular Degeneration* / drug therapy

Substances

  • Vascular Endothelial Growth Factor A
  • Angiogenesis Inhibitors