VIDEO: Consider imaging biomarkers, demographic factors in geographic atrophy risk

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There are several to consider. I think the most important ones that are most well known are certainly age and family history, and this pathology is also much more common in Caucasian patients. If we look at the geographic atrophy clinical trials, they are primarily done in Caucasian patients with an average age of almost 80. And then smoking and genetic mutations are also very important ones to think about as risk factors for geographic atrophy and geographic atrophy progression. We don’t routinely check genetic mutations in clinical practice, but certainly something that’s been shown to be important in a research setting, but smoking is one that we can certainly counsel our patients on. And then from an imaging standpoint, there are several features to consider, and this is really a hot area, in fact, a hotly debated area in many situations. But there are features to look at that may put patients at risk for geographic atrophy on OCT imaging in particular. Some of the ones to consider are incomplete RPE and outer retinal atrophy, or iRORA, where there can be some choroidal hypertransmission that’s seen on OCT as with the classic GA lesion, but it doesn’t meet that full 250 µm threshold for complete RPE and outer retinal atrophy, or cRORA. So, these are things that we may not have been looking at as closely outside of a research setting, but now that we have some treatments available, it is important to try to identify patients earlier. So, definitely important to think about some of these imaging biomarkers and then also demographic factors.