BLOG: IRIS Registry helps characterize real-world progression of GA, wet AMD from dry AMD

ByTheodore Leng, MD, FACS

Fact checked byChristine Klimanskis, ELS

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

My colleagues and I, seeking to better assess the relationship between dry age-related macular degeneration and geographic atrophy, turned to the American Academy of Ophthalmology IRIS Registry.

The IRIS Registry — a clinical registry that houses aggregated data from thousands of practices across the United States — contains valuable information on 454 million patient visits. The curated, de-identified data are analyzed by Verana Health’s VeraQ population health data engine. I share a summary below of the research team’s findings, which were published in Ophthalmology and Therapy.

Patients diagnosed with dry AMD in at least one eye from 2016 to 2019 (index date) were included in the study, as long as they had at least one additional visit and visual acuity (VA) measurement after the index date. These parameters yielded approximately 593,000 patients who were included in the study. At baseline, approximately 64% and 29% of patients had mild or intermediate dry AMD, respectively, and approximately 6% of patients had geographic atrophy (GA) with or without subfoveal involvement.

Severity of disease at baseline correlated with VA measurements, with at least 20/63 VA in 88% of patients with mild dry AMD compared with only 28% of patients with subfoveal-involved GA. Conversely, among those with mild dry AMD and subfoveal-involved GA, respectively, 4% and 50% of patients had less than 20/160 VA.

Similarly, higher annual loss of VA letters was associated with worse baseline disease severity. Among our important findings on this front:

• Patients with mild and intermediate dry AMD lost 1.19 and 2.50 letters per year, respectively.
• Patients with GA with subfoveal involvement lost 2.50 letters per year.
• Patients with GA without subfoveal involvement fared the worst, losing 3.93 letters per year.

Progression to wet AMD and GA occurred considerably faster in patients who had intermediate dry AMD during the index period, and progression to wet AMD occurred at similar rates among those with baseline GA:

• Only 0.5% of patients with mild dry AMD at baseline had wet AMD at the end of the study compared with 8.0% of patients with intermediate dry AMD at baseline.
• Approximately 5.5% of patients with baseline intermediate dry AMD had GA by the end of the study compared with a 0.4% GA rate among those with mild dry AMD at baseline.
• Among those with subfoveal or non-subfoveal GA at baseline, 7.7% and 6.9%, respectively, had wet AMD at the end of the study.

These curated, de-identified real-world data from the IRIS Registry help complement those from randomized clinical trials and underscore that we urgently need an effective therapy for treating dry AMD and GA. Further, these data suggest that we should closely monitor patients with intermediate dry AMD for progression to wet AMD so that prompt treatment can be administered and long-term vision loss avoided.

Reference:

• Leng T, et al. Ophthalmol Ther. 2023;doi:10.1007/s40123-022-00583-y.

Published by: