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Recent approaches to evaluating and monitoring geographic atrophy

Chaikitmongkol, Voraporn; Tadarati, Mongkol; Bressler, Neil M.

Current Opinion in Ophthalmology: May 2016 - Volume 27 - Issue 3 - p 217–223
doi: 10.1097/ICU.0000000000000259
RETINAL, VITREOUS AND MACULAR DISORDERS: Edited by Brandon G. Busbee and John W. Kitchens
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Purpose of review Given the increasing prevalence of geographic atrophy from age-related macular degeneration as the number of individuals over 85 increases throughout the world, as well as the recent increase in potential treatments to slow growth of geographic atrophy, this article discusses recent findings regarding retinal imaging of geographic atrophy to detect its presence or expansion over time.

Recent findings During the review period, the COMPLETE (Systemic complement inhibition with eculizumab for geographic atrophy in age-related macular degeneration) and the GATE (Randomized trial to evaluate tandospirone in geographic atrophy secondary to age-related macular degeneration) studies, respectively, reported no beneficial effects of intravenous eculizumab or tandospirone eye drops, respectively, identified on the growth of geographic atrophy. Several imaging and visual function studies have evaluated the role of various techniques using fundus autofluorescence, optical coherence tomography, microperimetry, or other investigator-initiated tools to assess geographic atrophy growth or progression over time, although the ideal imaging for geographic atrophy remains unknown. Some predictive factors for geographic atrophy growth recently suggested include genetic features, geographic atrophy characteristics in the fellow eye, or the presence of outer retinal tubulation on optical coherence tomography.

Summary Quantification of geographic atrophy is important for evaluating growth of geographic atrophy. Numerous new imaging techniques of geographic atrophy beyond human grading of fundus photographs or fluorescein angiograms have emerged, but the ideal imaging for geographic atrophy has yet to be determined.

aRetina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

bRetina Division, Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

cRetina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence to Neil M. Bressler, MD, Maumenee 752, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287–9277, USA. Tel: +1 410 955 8342; e-mail: nmboffice@jhmi.edu

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