Advice to Physicians Treating Geographic Atrophy


Drs Eleonora M. Lad, David R. Lally, Jaynath R. Sridhar, and Nancy M. Holekamp share takeaways for health care professionals taking care of patients with geographic atrophy and earlier stages of age-related macular degeneration.

Eleonora Lad, MD, PhD: I have 1 last question for all 3 of you. I’ll start with David. What advice do you have for ophthalmologists and other health care professionals taking care of our patients with geographic atrophy [GA] or the earlier stages of age-related macular degeneration?

David R. Lally, MD: The take-home message is that the times are changing. It’s no longer the mantra of, “We can’t do anything for dry age-related macular degeneration. We can’t do anything for geographic atrophy. We play no role in altering the course of that disease.” Hopefully, it’s a new day and a new time for our patients and our communities, so don’t hesitate to send us any patient you suspect may have signs of [age-related] macular degeneration. We’re happy to evaluate them and determine whether they qualify for the therapy and follow up with you about what we found.

Eleonora Lad, MD, PhD: Jay?

Jayanth Sridhar, MD: We’re fortunate to be retina specialists. I love what we do—we all love what we do—and this is a very exciting time. We finally have treatment for something we never had treatment for, and breakthroughs like this shouldn’t be taken for granted in medicine. For our colleagues out there, it’s important for them to know that we have options and that there are things we can do. As Dave said, get these patients in to see us so we can start stratifying them, because it’s going to come in a rush. We’re going from no treatment at all to 1 option and then potentially another option. It’s a very exciting time, and it’s a privilege to be here.

Nancy M. Holekamp, MD, FASRS: I don’t want our colleagues to be underwhelmed by the 20% slowing of the growth rate of GA lesions, give or take some percentage points. This is the first treatment that alters the course of this neurodegenerative disease. I hope everyone will look at the FDA label once we get an approval and have a discussion with patients. Try to avoid a paternalistic approach to patient care, where we don’t think they’ll benefit. It’s hard for us to quantify and understand the disease burden caused by GA. We can’t hang our hats on visual acuity, and we may not be good communicators with our patients. Patients will select themselves. I encourage my colleagues to have a discussion with every patient who meets the label so that they understand the value proposition and to see if they want to proceed with this course of treatment.

Eleonora Lad, MD, PhD: Well said. Before we conclude, I’d like to get brief final thoughts from each of you. David?

David R. Lally, MD: This has been an excellent discussion. I learned a lot. It’s been a pleasure to hear all your voices. I’ve learned a lot listening to you guys. Thank you for having me.

Jayanth Sridhar, MD: I agree 100%. This is where the magic happens. I love these discussions. I always learn a lot. Hopefully the audience learned a lot. Thank you for having us, Nora.

Eleonora Lad, MD, PhD: Nancy?

Nancy M. Holekamp, MD, FASRS: I learned that in my injection clinics I’m going to have to monitor patients for safety, so thank you for that pearl.

Eleonora Lad, MD, PhD: I couldn’t agree more. I’d like to thank you all for the very rich and informative discussion. I’d like to thank the audience. If you enjoyed the content, please subscribe to our e-newsletters to receive upcoming Peer Exchanges and other great content right in your in-box. Thank you.

Transcript edited for clarity

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