Decision-making for geographic atrophy treatment multifactorial
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WAILEA, Hawaii — When making treatment decisions for geographic atrophy, atrophy geometry, lesion size and focality are some of the features that must be considered, according to a speaker here.
“The treatment decision is somewhat complicated and multifactorial,” Glenn J. Jaffe, MD, said at Retina 2024.
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When deciding if and how to treat geographic atrophy (GA), retina specialists should evaluate the distance to the foveal center, focality and lesion growth rate, Jaffe said. The patient’s insurance should also be evaluated, and social considerations should be kept in mind.
“Can the patient come in every month or every 2 months? Can they get their relative to drive them, or can they drive themself?” he said. “That can be an issue because they are getting an injection.”
To aid with treatment decisions, Jaffe shared his approach to imaging.
“I will use an en face image to get an idea of whether the atrophy is present,” he said. “Then I use the CAM criteria with OCT to establish a diagnosis.”
When counseling patients, it is important to discuss that treatment will slow the growth rate of GA and that visual function is likely to decline, as well as a detailed analysis of the benefits vs. risks of treatment.
“You have to tell the patient, ‘This is treatment for life,’” Jaffe said.
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Jaffe GJ. How do I decide to treat patients with geographic atrophy? Presented at: Retina 2024; Jan. 13-19, 2024; Wailea, Hawaii.
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