Points of View: Geographic Atrophy

Sheppard, MD: At-home diagnostics are making great advances for age-related macular degeneration, which should also benefit our geographic atrophy patients. Not only are simple daily standardized subjective functional tests available through home telephone or internet channels available to virtually every patient at risk, but objective retinal imaging technology is coming to the forefront of regular home screening protocols.

Adyanthaya, MD: Future treatments will likely target other components of the complement cascade. These may work in a slightly different and hopefully better way. More effective complement inhibitors might stop atrophic lesions from progressing rather than just slowing them down. Stem cells and gene therapy, although still in their infancy, might provide a major breakthrough in the future. The use of artificial intelligence may make the diagnosis of geographic atrophy more streamlined and help detect and diagnose early lesions so that treatments could be started sooner.

Rachon, OD, FAAO: I expect to see the complement inhibitors improved upon. Right now, not everybody qualifies for those injections, but I expect that over time we will see the release of injections and medications with a higher percentage of reduction of progression greater than 20% to 35%, maybe injections that don’t have to be done every month. I anticipate that these treatments are going to improve in efficacy and safety. The other thing that is big in all aspects of ocular conditions is gene therapy and cell therapy. There are a number of gene therapy trials ongoing right now that involve reintroducing genes that can code a better production for the complement pathway and repair that path. Eventually, the goal, as with any other ocular condition, is to eliminate the need for any medication and to have a complete cure for geographic atrophy.