Abstract
Purpose :
Geographic atrophy (GA) is the atrophic form of late-stage age-related macular degeneration (AMD) and is the leading cause of blindness in the developed world. This study aims to characterize the journey of patients with GA in real-world ophthalmology practice.
Methods :
This is a retrospective cohort study of patients diagnosed with GA at a large academic center. The electronic medical record was searched for relevant data regarding demographics, past medical history, and signs of disease presentation and progression. Descriptive statistical analysis was performed, with continuous variables reported using mean ± standard deviation and categorical variables reported using percentages.
Results :
Data from 62 patients who developed GA in at least one eye was assessed from the time of AMD diagnosis to most recent follow-up (5.62±3.03 years). 71% of patients (n=44) were female. Patients commonly presented with complaints of blurred vision (53%), difficulty reading (44%), and decreasing vision (42%) at the time of diagnosis. The average visual acuity (VA) upon initial AMD diagnosis was 67±16 ETDRS letters (20/45), and 19 patients’ VA decreased to “counting fingers” or worse by their last visits; average VA decreased to 41±30 ETDRS letters (20/160). 29% of patients had GA in at least one eye at the time of initial AMD diagnosis, and 23% of patients presented with bilateral GA. 42% of patients received initial AMD diagnoses from retina specialists, while 55% were diagnosed by other ophthalmologists and 3% by optometrists. On average, patients had 2.8±3.0 visits with retina specialists per year and 2.0±2.5 visits with other ophthalmologists after diagnosis. Throughout their follow-up, 94% of patients’ vision declined below 20/40 in both eyes, 15% of patients developed legal blindness, and 37% were referred to a low vision center. 40% were diagnosed with depression at some point after their AMD diagnosis, 27% were admitted to the hospital at least once due to a fall, and 60% reported requiring assistance with activities of daily living due to vision decline.
Conclusions :
The progressive nature of GA makes it a difficult disease to manage in everyday practice. Many patients have already progressed to GA by the time they receive an AMD diagnosis, and the symptoms which patients with GA experience including long-term VA deficits lead to significant effects on quality of life.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.