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Geographic atrophy
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Seeing the Whole Patient
A psychosocial history is fundamental to every patient assessment to understand their ability to perform activities of daily living and individual management goals. Some patients assume their difficulties with tasks or vision loss are signs of getting older and do not voice any concern. Therefore, you may need to proactively engage them in conversations about their day-to-day activities.
Connect With Your Patients on the Following:
Understanding GA
Current Impact
Future Monitoring
Educate to Empower
Discuss Aspects of the Expected Clinical Course With Your Patients By:
Describing GA and explaining the impact it may have
Reviewing the goals of management
Defining the importance of regular monitoring
Emphasize your patients’ role in partnering with all eye care professionals involved in their care.
Partnership Is Essential
Early alignment with your eye care colleagues will maximize engagement with your patients.
Key Considerations for GA Patient Referrals
WHO: Identify which patients to refer and when in their course of disease to discuss treatment
WHAT: Assess baseline images and functional changes
Get Started
This resource can help assist with referrals to provide complete care for patients.
Referral Guide
Assessing and Counseling Patients
Seeing the Whole Patient
A psychosocial history is fundamental to every patient assessment to understand their ability to perform activities of daily living and individual management goals. Some patients assume their difficulties with tasks or vision loss are signs of getting older and do not voice any concern. Therefore, you may need to proactively engage them in conversations about their day-to-day activities.
Connect With Your Patients on the Following:
Understanding GA
Current Impact
Future Monitoring
Educate to Empower
Discuss Aspects of the Expected Clinical Course With Your Patients By:
Describing GA and explaining the impact it may have
Reviewing the goals of management
Defining the importance of regular monitoring
Emphasize your patients’ role in partnering with all eye care professionals involved in their care.
Collaborating With Colleagues
Partnership Is Essential
Early alignment with your eye care colleagues will maximize engagement with your patients.
Key Considerations for GA Patient Referrals
WHO: Identify which patients to refer and when in their course of disease to discuss treatment
WHAT: Assess baseline images and functional changes
Get Started
This resource can help assist with referrals to provide complete care for patients.
Referral Guide
References
- Holz FG, Schmitz-Valckenberg S, Fleckenstein M. Recent developments in the treatment of age-related macular degeneration. J Clin Invest. 2014;124(4):1430-1438.
- Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, Henry EC, Brittain C. The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target. Retina. 2017;37(5):819-835.
- Fleckenstein M, Mitchell P, Freund KB, et al. The progression of geographic atrophy secondary to age-related macular degeneration. Ophthalmology. 2018;125(3):369-390.
- Sadda SR, Chakravarthy U, Birch DG, et al. Clinical endpoints for the study of geographic atrophy secondary to age-related macular degeneration. Retina. 2016;36(10):1806-1822.
- Monés J, Garcia M, Biarnés M, Lakkaraju A, Ferraro L. Drusen ooze: a novel hypothesis in geographic atrophy. Ophthalmol Retina. 2017;1(6):461-473.
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- Ambati J, Ambati BK, Yoo SH, Ianchulev S, Adamis AP. Age-related macular degeneration: etiology, pathogenesis, and therapeutic strategies. Surv Ophthalmol. 2003;48(3):257-293.
- Flaxel CJ, Adelman RA, Bailey ST, et al. Age-related macular degeneration preferred practice pattern(R). Ophthalmology. 2020;127(1):P1-P65.
- Sunness JS, Rubin GS, Applegate CA, et al. Visual function abnormalities and prognosis in eyes with age-related geographic atrophy of the macula and good visual acuity. Ophthalmology. 1997;104(10):1677-1691.
- Lindblad AS, Lloyd, PC, Clemons TE, et al. Change in area of geographic atrophy in the Age-Related Eye Disease Study: AREDS report number 26. Arch Ophthalmol. 2009;127(9):1168-1174.
- Holz FG, Strauss EC, Schmitz-Valckenberg S, van Lookeren Campagne M. Geographic atrophy: clinical features and potential therapeutic approaches. Ophthalmology. 2014;121(5):1079-1091.
- Desai D, Dugel PU. Complement cascade inhibition in geographic atrophy: a review. Eye (Lond). 2022;36(2):294-302.
- Bakri SJ, Bektas M, Sharp D, Luo R, Sarda SP, Khan S. Geographic atrophy: mechanism of disease, pathophysiology, and role of the complement system. J Manag Care Spec Pharm. 2023;29(5-a Suppl):S2-S11.
- Carlton J, Barnes S, Haywood A. Patient perspectives in geographic atrophy (GA): exploratory qualitative research to understand the impact of GA for patients and their families. Br Ir Orthopt J. 2019;15(1):133-141.
- Stahl A. The diagnosis and treatment of age-related macular degeneration. Dtsch Arztebl Int. 2020;117(29-30):513-520.
- Sayegh RG, Sacu S, Dunavölgyi R, et al. Geographic atrophy and foveal-sparing changes related to visual acuity in patients with dry age-related macular degeneration over time. Am J Ophthalmol. 2017;179:118-128.
- Chakravarthy U, Bailey CC, Johnston RL, et al. Characterizing disease burden and progression of geographic atrophy secondary to age-related macular degeneration. Ophthalmology. 2018;125(6):842-849.
- Patel PJ, Ziemssen F, Ng E, et al. Burden of illness in geographic atrophy: a study of vision-related quality of life and health care resource use. Clin Ophthalmol. 2020;14:15-28.
- Singh RP, Patel SS, Nielsen JS, Schmier JK, Rajput Y. Patient-, caregiver-, and eye care professional-reported burden of geographic atrophy secondary to age-related macular degeneration. Am J Ophthalmic Clin Trials. 2019;2(1):1-6.
- Sivaprasad S, Tschosik EA, Guymer RH, et al. Living with geographic atrophy: an ethnographic study. Ophthalmol Ther. 2019;8(1):115-124.
- Higgins BE, Taylor DJ, Binns AM, Crabb DP. Are current methods of measuring dark adaptation effective in detecting the onset and progression of age-related macular degeneration? A systematic literature review. Ophthalmol Ther. 2021;10(1):21-38.
- Meleth AD, Mettu P, Agron E, et al. Changes in retinal sensitivity in geographic atrophy progression as measured by microperimetry. Invest Ophthalmol Vis Sci. 2011;52(2):1119-1126.
- Xu H, Chen M. Targeting the complement system for the management of retinal inflammatory and degenerative diseases. Eur J Pharmacol. 2016;787:94-104.
- Coulthard LG, Woodruff TM. Is the complement activation product C3a a proinflammatory molecule? Re-evaluating the evidence and the myth. J Immunol. 2015;194(8):3542-3548.
- Xie CB, Jane-Wit D, Pober JS. Complement membrane attack complex: new roles, mechanisms of action, and therapeutic targets. Am J Pathol. 2020;190(6):1138-1150.
- Brandstetter C, Holz FG, Krohne TU. Complement component C5a primes retinal pigment epithelial cells for inflammasome activation by lipofuscin-mediated photooxidative damage. J Biol Chem. 2015;290(52):31189-31198.
- Kumar-Singh R. The role of complement membrane attack complex in dry and wet AMD – from hypothesis to clinical trials. Exp Eye Res. 2019;184:266-277.