Missing a single ophthalmology appointment over a two-year period was associated with decreased visual acuity for patients with macular degeneration—a leading cause of permanent vision loss in the elderly—according to a new Penn Medicine study. The findings, published in JAMA Ophthalmology, suggest that more attention should be paid to ensuring visit adherence for this patient population. The authors say the results of the study also have financial implications for clinicians, due to impending changes in Medicare reimbursement. These changes will reportedly shift financial risks to the physician, while also accounting for patient outcomes.
Age-related macular degeneration (AMD) happens when debris builds up in the central portion of the retina, called the macula, causing it to lose function, which leads to gradual wavy or blurred eyesight. There are two types: dry, which is more common and less serious, and wet, which is less common but much more severe. AMD is the leading cause of permanent vision loss in people over age 50, with an estimated 1.8 million Americans suffering and another 7.3 million at risk of developing the disease, according to the Centers for Disease Control and Prevention.
While there is no cure for wet AMD, vision can be maintained and often improved with anti-VEGF (intravitreal anti-vascular endothelial growth factor) drugs, which must be injected into the eye by an ophthalmologist. However, this treatment comes with a significant burden to the patient—mandating frequent, sometimes monthly, trips to the eye doctor.
“Research of other diseases has shown the importance of appointment adherence. In patients with HIV, for example, studies have found that showing up to appointments has been linked to lower mortality rates and reduced viral loads. But unlike HIV patients, who can have prescriptions filled over the phone by any physician, anti-VEGF therapy can only be administered by an ophthalmologist, making visit adherence even more critical for those with macular degeneration,” says Brian VanderBeek, a professor of ophthalmology at the Perelman School of Medicine. “I wanted to quantify the link between regular visits to the eye doctor and visual outcomes for these patients.”
Read more at Penn Medicine News.