Dr. Arif Samad
MD, FRCSC, FACS, Ophthalmologist specializing in diseases of the Retina & Vitreous, and Associate Professor, Department of Ophthalmology & Visual Sciences, Dalhousie University
The health threats of the pandemic go far beyond COVID-19 itself, including the disruption of unrelated medical care. The pandemic has shifted daily patterns of life for everyone, but for some the effect has been more extreme.
Take a look around at the reality we’re living in and imagine how much more challenging this time would be if one of the things we often take for granted, our vision, was at risk. For Canadians living with age-related macular degeneration (AMD) this is a real concern. COVID-19 has provoked anxiety for this group, with some feeling that it is now necessary to weigh the danger of contracting COVID-19 against the danger of losing vision.
AMD is a progressive eye disease of the macula, which is near the central region of the retina. “The natural history of AMD is characterized by progression with age,” explains Dr. Samad, Ophthalmologist specializing in diseases of the Retina and Vitreous, and Associate Professor, Department of Ophthalmology and Visual Sciences, Dalhousie University.
Vision loss has a profound impact on patients; they can no longer drive, their independence is lost, they can’t read or see the faces of their loved ones.
There are two types of AMD: “dry” AMD, which causes slower vision loss but can in a few cases progress over time into neovascular, or “wet,” AMD (nAMD), where new blood vessels grow and bleed under the macula, leading to profound and permanent loss of sight that progresses rapidly. “Vision loss has a profound impact on patients; they can no longer drive, their independence is lost, they can’t read or see the faces of their loved ones,” says Dr. Samad.
Vision loss from nAMD cannot be reversed, but it can be prevented
nAMD is treatable but not curable. Treatment usually involves regular injections into the eye to help reduce the growth of new blood vessels and slow leakage from blood vessels, which can cause vision deterioration. Dr. Samad underscores that “treatment is long-term and requires compliance.” Even in the best of times, getting regular injections can be difficult, especially for those living in remote locations, requiring assistance, or managing other health conditions.
In combination with anxiety and fear around the method of administration, the burden of frequent appointments, especially during a pandemic, may lead to treatment discontinuation. A U.S. data review has estimated that up to 50 percent of nAMD patients did not persist with their treatment by the second year, with most dropping out within 6 to 12 months of starting therapy. According to a global survey of patients and their caregivers, frequency of injections was one of the key obstacles to proper care, along with having injections, and possible injection-related side effects.
It is important to know that not all nAMD patients will have the same treatment frequency based on their disease activity. Knowing your options is key. With the help of your ophthalmologist or retinal specialist, it is possible to find a treatment that is right for you.
If you or your loved one are living with nAMD, speak to your ophthalmologist or retinal specialist to determine which option may be right for you.
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