Eye diseases

Maculopathies as a social emergency: patients demand homogeneous treatment

From prevention and early diagnosis to recognition as chronic diseases and full integration of care pathways: the associations' demands for equal access and cost reduction

by Michele Allamprese *

24 March 2026

3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

The ageing of the population is profoundly redefining the country's health needs, presenting the National Health Service with increasingly complex challenges. Among the most urgent - and still too underestimated - are maculopathies: highly prevalent pathologies, strongly disabling and destined to grow significantly in the coming years.

As Apmo-Association for Patients with Ocular Diseases, we observe the concrete consequences of these diseases every day: progressive loss of sight, reduction of autonomy, direct impact on quality of life and families.This is not just a clinical problem, but a real social emergency.

Socio-economic impact

International estimates confirm a steady increase in the number of cases of age-related macular degeneration, with a significant impact not only on the clinical but also on the social and economic level. In Italia, the number of intravitreal injections - today the gold standard of treatment - has reached between 300 and 400 thousand procedures per year. However, compared to other major European countries, significant inequalities in access to treatment persist. This reflects, on the one hand, the progress in medicine and, on the other, the increasing pressure on ophthalmology services, waiting lists and the overall organisation of care.

Those excluded from care

Faced with these numbers, however, a structural criticality remains: a significant proportion of patients still do not access treatment in a timely and continuous manner. This translates into a real risk of avoidable visual loss, with profound effects on quality of life, individual autonomy and the burden of care for families and caregivers.

For these reasons, tackling maculopathies means adopting a systemic vision, capable of integrating prevention, early diagnosis and ongoing care in an accurate management of the available resources.Today, the real crux is not the availability of effective therapeutic solutions, but the system's ability to guarantee fair and homogeneous access throughout the country. Regional differences in organisational models and treatment paths continue to generate inequalities that are no longer sustainable.

The Manifesto

It is in this context that the path of confrontation between patients' associations, clinicians and institutions, to which Apmo has actively contributed in all the stages that led to the definition of a Manifesto presented a few days ago at the Chamber of Deputies, fits in. A work that stems from the direct experience of patients and that identifies some priorities that can no longer be postponed.

The first concerns planning: it is necessary to strengthen prevention and early diagnosis policies, especially in the over-65 population, and to make the involvement of patient associations in decision-making processes structural.

The second is the recognition of maculopathies as chronic pathologies, with an explicit inclusion in the main national health planning instruments, starting with the National Chronicity Plan and the Essential Levels of Care.

A third crucial area is the development of homogeneous, measurable and truly implemented diagnostic and therapeutic care pathways (Pdta) on a regional scale. Without shared organisational models, in fact, the risk is that of continuing to operate in a misaligned manner, with inefficiencies that directly affect patients.

Integration with the territory

Alongside this is the issue of integration between hospital and territory. Rethinking the organisation of centres for intravitreal therapies, also through a greater enhancement of proximity medicine and more flexible care settings, can help reduce waiting lists and improve therapeutic adherence.

But the central point remains one: we can no longer allow the loss of sight to depend on where one lives.

As a patients' association, we therefore believe that a paradigm shift is needed: from a fragmented approach to an integrated, fair and sustainable care model.

The chance of biosimilars

In this context, the sustainability of the system can also be concretely strengthened through greater recourse to biosimilar drugs, which, with the same efficacy and safety, enable savings estimated at between 40% and 80%, freeing up resources to be reinvested in personnel, organisation and access to care. An objective that can only be achieved through structured and continuous collaboration between all the players in the system.

Guaranteeing the right to sight ultimately means protecting people's quality of life and autonomy. And it is a responsibility that our healthcare system cannot afford to postpone. As Apmo we will continue to work to ensure that the right to sight is recognised as a public health priority. Because guaranteeing sight means guaranteeing autonomy, dignity and quality of life.

* Director APMO - Association of Patients with Ocular Diseases