Ferhina S. Ali, MD, MPH

Panelists discuss how they encourage hesitant colleagues to adopt geographic atrophy therapies by emphasizing the importance of staying current with clinical trial data, starting with highly motivated patients who mirror trial populations, and express excitement about the future of precision medicine through biomarker-guided treatment selection, advanced imaging with artificial intelligence integration, late-stage trials targeting vision as primary end points, and innovative approaches like gene therapy and cell therapy that may eventually restore vision.

Panelists discuss how they explain treatment success to patients with geographic atrophy by emphasizing that although the disease will continue to progress, clinical trial data show that the therapy slows the rate of growth by 20% to 30% on average, acknowledging that individual patient responses vary along a bell curve and that preserving retinal tissue is inherently meaningful for visual function even without immediate measurable vision improvements.

Panelists discuss how they manage patients requiring both wet age-related macular degeneration (AMD) and geographic atrophy (GA) treatments by administering injections on separate days rather than on the same day to avoid workflow disruption, address the increased intraocular pressure from the larger 100-µL complement inhibitor dose by allowing patients time to acclimate in the chair with only a small percentage requiring pressure-relieving taps, and acknowledge that although this dual-therapy population represents a minority of their patients undergoing complement modulation, these experienced injection recipients are typically very accepting of additional treatments.

Panelists discuss how they present the modest efficacy of geographic atrophy (GA) therapies to patients by framing treatment as maintenance therapy that slows progression rather than providing improvement, using prior imaging to demonstrate disease advancement, acknowledging the inherent risk of developing wet age-related macular degeneration (AMD) while emphasizing that this preexisting risk is increased with complement inhibitor therapy, and offering hope for more effective future treatments.

Panelists discuss how they approach therapy selection between the 2 FDA-approved geographic atrophy treatments by comparing pegcetacoplan’s potentially greater efficacy signals with avacincaptad pegol’s superior safety profile, with treatment choice often driven by individual patient factors such as motivation level, monocular status, and willingness to accept risk, while emphasizing that starting monthly dosing provides the best fallback position when patients experience treatment fatigue.

Panelists discuss how their management approach for geographic atrophy (GA) has evolved from a “come back in a year” mentality to actively offering treatment discussions within 2 to 3 months, with most patients showing interest in complement inhibitor therapy, particularly those with functional vision remaining who understand the progressive nature of their disease and have vision left to preserve.

Panelists discuss how conversations with patients with geographic atrophy have evolved to emphasize the urgency of early intervention, with clinicians now able to offer hope through available treatments that can slow disease progression, while helping patients understand that their current vision represents the best they will ever have and leveraging family history awareness to motivate treatment consideration.

Panelists discuss how geographic atrophy (GA) presentations show clinical variability across patients while remaining consistently progressive, requiring a combination of imaging modalities including fundus photography, fundus autofluorescence, and OCT for diagnosis and monitoring, with OCT being most practical for routine clinical visits despite fundus autofluorescence serving as the gold standard for clinical trials.

Ferhina S. Ali, MD, MPH, discusses the management of progressive geographic atrophy in an 84-year-old man, focusing on the significance of patient education in optimizing treatment outcomes and adherence.

Ferhina S. Ali, MD, MPH, discusses management and treatment considerations for an 89-year-old woman with dry age-related macular degeneration (AMD) and geographic atrophy (GA), emphasizing the importance of monitoring for choroidal neovascularization and addressing the patient’s progressive vision loss.

Ferhina S. Ali, MD, MPH, discusses how to effectively manage geographic atrophy by considering treatment timing, utilizing imaging modalities, analyzing phase 3 trial data, and developing personalized treatment algorithms based on disease severity while highlighting the encouraging compliance of patients undergoing long-term therapies.