June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Characterizing the patient journey of geographic atrophy patients in routine ophthalmic practice
Author Affiliations & Notes
  • Urvi Gupta
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Christopher M Maatouk
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cleveland Clinic, Cleveland, Ohio, United States
  • Katherine Talcott
    Center for Ophthalmic Bioinformatics, Cleveland Clinic, Cleveland, Ohio, United States
  • Rishi Singh
    Cleveland Clinic Martin Hospitals, Cleveland Clinic Florida, Stuart, Florida, United States
  • Aleksandra V. Rachitskaya
    Center for Ophthalmic Bioinformatics, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Urvi Gupta None; Christopher Maatouk None; Katherine Talcott Zeiss, Regenxbio, Code F (Financial Support), Genentech, Roche, Code I (Personal Financial Interest); Rishi Singh Genentech, Roche, Alcon, Novartis, Regeneron, Asclepix, Gyroscope, Bausch and Lomb, Apellis, Code I (Personal Financial Interest); Aleksandra Rachitskaya Alcon, Genentech, Apellis, Iveric Bio, Zeiss, Regeneron, Code C (Consultant/Contractor), AGTC, Apellis, Genentech, NGM Bio, Code F (Financial Support)
  • Footnotes
    Support  This work was supported by P30EY025585, Research to Prevent Blindness (RPB) Challenge Grant, Cleveland Eye Bank Foundation Grant
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2256. doi:
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      Urvi Gupta, Christopher M Maatouk, Katherine Talcott, Rishi Singh, Aleksandra V. Rachitskaya; Characterizing the patient journey of geographic atrophy patients in routine ophthalmic practice. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2256.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

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