Early detection and treatment of geographic atrophy (GA) are critical for preserving vision, according to experts at the American Academy of Optometry (AAOpt) 2024 meeting. Steve Ferrucci, OD, FAAO, emphasized the importance of multimodal imaging for early diagnosis and highlighted the potential of new FDA-approved therapies to slow disease progression.
The Importance of Early Detection
Dr. Ferrucci stressed that recognizing GA is the first step in managing the condition, especially now that treatments are available. "If you can't detect it, you really can't do anything," he noted. Multimodal imaging, including color fundus photos, fundus autofluorescence, and optical coherence tomography (OCT), plays a crucial role in identifying GA. Each modality offers unique advantages, and using multiple tools can enhance detection accuracy.
Emerging Therapies for GA
Two recently FDA-approved medications, Syfovre and Izervay, have shown promise in slowing the progression of GA. These treatments can reduce the rate of lesion growth by 25-35%, potentially preserving usable vision for a longer period. Dr. Ferrucci explained that these medications work by slowing down the growth of geographic atrophy lesions, thereby allowing patients to have a longer time with usable vision.
Identifying Patients for Referral
Specific patient characteristics should prompt referral to a retinal specialist. Dr. Ferrucci advised that patients with extrafoveal lesions or those exhibiting hyperfluorescence around lesions on fundus autofluorescence are likely to benefit from treatment. Observing clear progression of lesions, particularly those approaching the macula, is another critical indicator for referral.
The Role of Optometry
Optometrists are often the first point of contact for patients with GA, particularly since effective treatments have only recently become available. Dr. Ferrucci emphasized that optometrists should proactively screen for GA in their patients. OCT is a valuable tool for detecting GA, with hypertransmission defects on cross-sectional images indicating areas of atrophy.
Impact on Vision and Independence
Slowing the progression of GA can have a significant impact on patients' quality of life. By preventing lesions from reaching the macula and causing vision loss, these treatments can help patients maintain their independence and continue activities such as driving. Dr. Ferrucci noted that vision loss from GA can progress more rapidly than previously thought, making prompt referral and treatment essential.
