Evaluation of OCT, uveitis history useful during patient selection for GA therapeutics
Key takeaways:
- Careful evaluation of imaging is important when deciding who to treat with approved geographic atrophy drugs.
- Fellow eye status and ellipsoid zone integrity are also key factors.
KOLOA, Hawaii — Assessing fellow eye status, age and history of uveitis are helpful ways to determine which patients are most likely to benefit from treatment with FDA-approved drugs for geographic atrophy, according to a speaker.
“What I do stress is looking at the lesion growth of prior photographs. Many of us have an extensive history of photos for a lot of these patients,” Robert L. Avery, MD, said during a presentation at Retina 2025. “If we don’t have that, then I use a careful inspection of the ellipsoid zone [EZ].”
Patient difficulties with treatment burden, risk factors for growth, location and size of the lesion are also important to consider, he explained. Avery also advised against treating patients with the double-layer sign on their OCT, which can “increase your risk significantly for developing choroidal neovascularization with these treatments.”
EZ integrity is also a helpful predictor for patients’ future rate of GA growth, and zone integrity preservation is an approvable endpoint for dry AMD, Avery said.
“Use clinical judgment for ruling out patients. Don’t treat patients that you have a higher risk of causing problems with,” he concluded. “Carefully look at the OCT for changes in the EZ zone around the GA.”
Collapse
Avery RL. How do I select which patients to treat with our approved GA drugs? Presented at: Retina 2025; Jan. 18-24, 2025; Koloa, Hawaii.
Read more about