Clinical Insights Shaping Real-World Decision-Making in Geographic Atrophy

In this concluding segment, the faculty synthesized major learnings drawn from the three geographic atrophy (GA) case discussions. They emphasized that lesion proximity to the fovea—rather than age alone—strongly guides treatment decisions, as patients experience significant vision loss once atrophy crosses the foveal center. The panel reiterated the practical strategy of treating the worse eye first when initiating bilateral therapy due to the small but real risk of early post-injection inflammation. From the second case, discussions reflected on the importance of understanding natural history, noting that progression without treatment reinforces the value of therapy even though GA inevitably worsens despite intervention.

The third case highlighted the challenges of managing concurrent neovascular AMD and GA, where distinguishing mixed-mechanism atrophy remains difficult and treatment patterns vary widely. Across all cases, the experts underscored individualized care, functional status assessment, shared decision-making, and the emerging need for AI-based longitudinal imaging tools. They concluded by noting the unique value of multidisciplinary, case-based discussions in refining both clinical judgment and communication strategies with patients.