Travel Distance and Demographics Predict Dropout in Wet AMD Care
A Canadian multicenter cohort found that 21% of patients receiving treatment for wet age-related macular degeneration stopped attending follow-up visits over a mean of 65.5 months. Longer travel distance, Black or Hispanic ethnicity, male sex, and multiple comorbidities increased the odds of being lost to follow-up, while older age and higher treatment burden reduced those odds. The authors suggest these findings can guide targeted retention strategies for high-risk patient groups.
The analysis, published in the *Canadian Journal of Ophthalmology*, tracked 2,556 patients over roughly five and a half years. Researchers noted that older patients, specifically those 90 and above, showed lower dropout rates despite the logistical challenges of frequent appointments.
Because Ontario's single-payer system covers treatment costs, financial barriers were not modeled. This contrasts sharply with the U.S., where rising copay losses and insurance type—such as Medicaid versus private coverage—have been linked to higher dropout odds in separate national research.
The findings could help clinics design targeted outreach for patients facing geographic or demographic hurdles, potentially reducing preventable blindness. If retention strategies focus on travel assistance or culturally tailored support, high-risk groups may maintain sight-saving regimens. However, without addressing systemic cost barriers in countries like the U.S., even well-identified risk factors may remain unaddressed, leaving vulnerable populations disproportionately affected by vision decline.