OCT-Defined Atrophic Age-Related Macular Degeneration Changes Associated with Deep Visual Sensitivity Losses: A Multicenter Study.

Purpose: To identify combination(s) of OCT changes that define atrophic age-related macular degeneration (AMD) lesions associated with repeatable deep visual sensitivity defects.

Design: Reader study.

Participants: One hundred seventy-one OCT scans from 60 eyes of 53 participants.

Controversies, Consensuses and Guidelines on Etiology, Diagnosis, Treatment, and Future Developments of Neovascular Age-Related Macular Degeneration (nAMD) by the Asia-Pacific Vitreo-retina Society (APVRS), the Asia-Pacific Ocular Imaging Society (APOIS) and the Academy of the Asia-Pacific Professors of Ophthalmology (AAPPO).

Neovascular age-related degeneration (nAMD) is one of the leading causes of visual impairment in older populations in the developed world. With the aging population, the incidence of nAMD is growing globally. Despite advancements in diagnostic investigations and treatment modalities over the past three decades, there remains considerable controversies in the pathogenesis, classification and optimal management strategies.

Targeted Defect-Mapping Microperimetry in Geographic Atrophy: A Sensitive Functional Outcome Measure for Intervention Trials.

Purpose: To evaluate the effectiveness of targeted defect-mapping microperimetry (DMP) for capturing progressive visual function loss in eyes with a small extent of geographic atrophy (GA).

Design: Prospective longitudinal study.

Participants: Twenty-seven eyes from 25 participants with <0.

Effect of Subthreshold Nanosecond Laser on Loss of OCT Outer Retinal Bands in Age-Related Macular Degeneration: A LEAD Study Report.

Purpose: To evaluate the effect of subthreshold nanosecond laser (SNL) treatment on the rate of loss of the OCT outer retinal bands in intermediate age-related macular degeneration (AMD).

Design: Post hoc analysis of the Laser Intervention in the Early Stages of AMD (LEAD) study.

Participants: A subset of 285 of 292 individuals in the LEAD study with bilateral large drusen without signs of multimodal imaging-defined late AMD at baseline, seen at 1 follow-up visit where neovascular AMD (nAMD) was absent.

Mapping the impact: AI-driven quantification of geographic atrophy on OCT scans and its association with visual sensitivity loss.

Background/aims: To examine the association between artificial intelligence (AI)-driven segmentation of geographic atrophy (GA) on optical coherence tomography (OCT) and visual sensitivity loss quantified by defect-mapping microperimetry, a testing strategy optimised to quantify the spatial extent of deep visual sensitivity losses.

Methods: 50 individuals with GA secondary to age-related macular degeneration underwent defect-mapping microperimetry testing within the central 8° radius region in one eye. GA on OCT was automatically segmented with an AI-based multiclass classification and segmentation model, and GA on fundus autofluorescence (FAF) images was manually annotated.

Onset of End-Stage Atrophic Age-Related Macular Degeneration as an End Point-A Delphi Study: Classification of Atrophy Meetings Report 7.

Purpose: To investigate whether consensus can be reached on the acceptability of end-stage atrophy onset as a clinical end point in early intervention trials of age-related macular degeneration (AMD), and the criteria for defining such an end point.

Design: A modified Delphi study.

Participants: International panel of experts in AMD, retinal imaging, and histopathology that are part of the Classification of Atrophy Meetings group.

Geographic atrophy: Understanding the relationship between structure and function.

Purpose: This review explores the complex relationship between anatomical alterations and functional consequences in geographic atrophy (GA), the advanced non-neovascular form of age-related macular degeneration. We examine the natural history, progression patterns, structural biomarkers, functional assessments, and structure-function correlations in GA.

Methods: Experts contributed specialized knowledge on GA pathophysiology, imaging biomarkers, and functional assessment methods.

Loss of OCT Outer Retinal Bands as Potential Clinical Trial Endpoints in Intermediate Age-Related Macular Degeneration.

Purpose: To understand the potential utility of evaluating loss of the outer retinal bands on OCT B-scans as outcome measures for early interventional trials in age-related macular degeneration (AMD).

Design: An observational study.

Participants: Two hundred eighty eyes from 140 participants with bilateral large drusen.

Customized Evaluation of Progressive Visual Sensitivity Loss in Geographic Atrophy to Improve the Power of Clinical Trials.

Purpose: To evaluate the effectiveness of different approaches for customizing the selection of a subset of test locations on defect-mapping microperimetry (DMP) for improving the detection of progressive visual function decline in geographic atrophy (GA).

Design: Prospective longitudinal study.

Participants: Sixty eyes from 53 participants with GA secondary to age-related macular degeneration.

Readiness of optometrists in the management of geographic atrophy: a survey of optometrists in Australia.

Clinical Relevance: Geographic atrophy is a leading cause of severe vision loss and is estimated to affect around 100,000 people in Australia alone. This survey is topical for clinical optometrists as the first treatment for geographic atrophy has just been approved by the Australian Therapeutics Goods Administration and may soon become available in Australia.

Background: Considering that treatments for geographic atrophy secondary to age-related macular degeneration are likely imminent, a survey of Australian optometrists was conducted to gauge their readiness in caring for people with geographic atrophy.

Reading Performance in Geographic Atrophy: Comparison of Different Reading Speed Measures for Capturing Longitudinal Changes.

Purpose: To compare different reading speed measures for capturing longitudinal visual function changes in eyes with geographic atrophy (GA) secondary to age-related macular degeneration.

Design: Analysis of data from Chroma (NCT02247479) and Spectri (NCT02247531), 2 identically designed, phase III, double-masked, randomized controlled clinical trials for lampalizumab.

Participants: Nine hundred forty participants aged ≥50 years old with bilateral GA, who completed monocular testing of reading speed at ≥3 visits over >1-year follow-up.

Nanosecond laser induces proliferation and improved cellular health within the retinal pigment epithelium.

Background: Age-related macular degeneration (AMD) is a leading cause of vision loss in those over 60 years of age. Although there are limited interventions that may prevent the development or progression of disease, more efficacious treatments are required. Short-pulsed laser treatment shows promise in delaying progression of early disease.

Designing the next generation of clinical trials in intermediate AMD-a consensus driven, pragmatic, proof of concept early intervention study.

A greater understanding of the pathophysiology of AMD has yielded potential therapeutic strategies for slowing vision loss. Structural imaging biomarkers and novel functional outcomes, both under intensive study as surrogate endpoints in AMD clinical trials, are new granular tools needed to assess disease progression and follow response to therapy. These advances have created, for the first time, the possibility to intervene early in AMD, and to measure success in a time frame feasible for clinical trials.

Retrospective audit reviewing accuracy of clinical diagnosis of geographic atrophy in a single centre private tertiary retinal practice in Australia.

Accurate diagnosis of both age-related macular degeneration (AMD) and inherited retinal diseases (IRD) with macular atrophy is important because treatments for both conditions are emerging. Phenotypical similarities between macular atrophy associated with AMD (geographic atrophy, GA) and IRD-associated atrophy exist, which can make accurate diagnosis challenging in clinical practice. Misdiagnosis may lead to inappropriate treatment strategies and missed opportunities for disease-specific interventions.

Visual Function Benefit After Treatment With Pegcetacoplan: Microperimetry Analysis From the Phase 3 Oaks Trial.

Purpose: To evaluate the impact of pegcetacoplan on its ability to slow the loss of visual function using microperimetry endpoints in eyes with geographic atrophy secondary to age-related macular degeneration (AMD).

Design: Post hoc analysis of phase 3 randomized controlled trial data.

Methods: Utilizing data from the OAKS study, which evaluated pegcetacoplan monthly (PM) or every other month (PEOM) vs sham for the treatment of GA secondary to AMD, microperimetry endpoints were assessed at baseline and every 6 months until 24 months, using a 10-2 grid composed of 68 points with a 4-2 threshold strategy.

Current advances in multimodal imaging in geographic atrophy secondary to age-related macular degeneration: A review.

As we move toward an era in which there will be treatment options for geographic atrophy (GA) secondary to age-related macular degeneration, the need to accurately understand and interpret multimodal imaging (MMI) for the condition is paramount. This review discusses the evolution of MMI in GA and how it has led to a greater understanding of different phenotypes and risk factors for progression. These advancements have allowed novel imaging biomarkers to be used as end points in large interventional studies exploring new therapies for GA treatment.

Local OCT Structural Correlates of Deep Visual Sensitivity Defects in Early Atrophic Age-Related Macular Degeneration.

Purpose: To determine local OCT structural correlates of deep visual sensitivity defects (threshold of ≤10 decibels on microperimetry) in early atrophic age-related macular degeneration (AMD).

Design: Prospective observational study.

Participants: Forty eyes from 40 participants, with at least incomplete retinal pigment epithelium (RPE) and outer retinal atrophy, or more advanced atrophic lesion(s).

Longitudinal Changes of Visual Sensitivity With Geographic Atrophy Progression Assessed by Defect-Mapping Microperimetry.

Purpose: To determine the relationship between structural and functional changes over time in the progression of geographic atrophy (GA) as assessed by defect-mapping microperimetry, an approach optimized to characterize the spatial extent of deep visual sensitivity losses.

Methods: A total of 57 eyes from 50 participants underwent defect-mapping microperimetry testing of the central 8° radius (with a 10-dB stimuli presented once each at 208 locations) over a median of five visits, scheduled at 3-monthly intervals. GA lesion(s) on fundus autofluorescence in the corresponding region tested on microperimetry at each visit were manually annotated.

Impairment of Neurovascular Function in Intermediate Age-Related Macular Degeneration.

Purpose: To investigate neurovascular function in eyes with age-related macular degeneration (AMD).

Methods: Subjects with bilateral large drusen (intermediate AMD) and healthy controls ≥50 years old were recruited. The vasculature within the central 6 × 6-mm retinal area was captured using optical coherence tomography angiography (OCTA) and segmented to return superficial plexus, deep plexus, choriocapillaris, and choroid.

Emerging treatments for geographic atrophy and the impact on clinical management of age-related macular degeneration.

Age-related macular degeneration (AMD) is a leading cause of vision impairment in people over 50 years of age and has a great impact on quality of life as it affects central vision. Although there have been treatments available for the neovascular form of late AMD for decades, until now there have not been treatments available for the atrophic form of late AMD - geographic atrophy (GA). Recently, treatments acting on the complement pathway have been approved by the United States Food and Drug Administration, with other jurisdictions such as Australia considering their approval.

Reticular Pseudodrusen: Impact of Their Presence and Extent on Local Rod Function in Age-Related Macular Degeneration.

Purpose: To understand the spatial relationship between local rod-mediated visual function and reticular pseudodrusen (RPD) in eyes with large drusen.

Design: Retrospective cross-sectional study.

Participants: One eye with large drusen (>125 μm) each from 91 individuals with intermediate age-related macular degeneration, with and without RPD.