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age-related macular degeneration (amd) is a disease that can lead to progressive loss of central vision. it was estimated that in 2019 more than 2.5 million canadians were living with amd, the leading cause of vision loss in people over the age of 50. there are two types of amd – “dry” amd, which is more common, and “wet” or neovascular amd (namd). while namd represents only 10 to 20 per cent of all amd cases, it is generally the most severe form of amd and is responsible for 90 per cent of vision loss associated with this disease.
“the thing that takes people’s vision away, by and large, is the growth of abnormal blood vessels underneath the central part of the retina,” explains dr. peter kertes, md, ophthalmologist and retinal specialist at sunnybrook health sciences centre in toronto. “these vessels may leak blood or other fluids, ultimately resulting in scarring of the macula, the central area of the retina.”
although namd cannot be cured, it is treatable. treatment consists of injections into the eye at regular intervals to help reduce the growth of abnormal or new blood vessels. “it may sound terrible, but, in truth, most patients tolerate it pretty well,” dr. kertes says. the frequency of injections depends on each patient, their disease activity, and the therapy used.
however, studies have noted that fear and anxiety related to the method of administration and long travel times to appointments for those living in remote locations, are just some of the reasons why, over time many patients miss or discontinue treatment altogether. some patients must be driven to their appointments, which can mean asking a caregiver to take a day off work, the doctor explains. others may be managing multiple health conditions, adding to the challenge.
despite these challenges, it is important to stay the course and persist with regular treatment. an american study observed that missing a single ophthalmology appointment over a two-year period was associated with decreased clarity or sharpness of vision for patients with namd.