At the 2025 meeting of the American Academy of Optometry, Nicole Ross, OD, MSc, FAAO, presented on imaging for dry age-related macular degeneration. Here she discusses key takeaways.

Transcript:

Hi, I'm Dr. Nicole Ross from the New England College of Optometry, and today I presented a lecture at the Academy Meeting with my colleague, Dr. David Ramsey, from the Department of Ophthalmology at Lahey Beth Israel.

Today we're focusing on non-neovascular, or dry age-related macular degeneration and its advanced form, geographic atrophy. This condition profoundly impacts vision, with its prevalence contributing significantly to very severe vision loss in older adults. The prevalence is anticipated to increase substantially by the year 2050, reaching up to maybe 222 million people.

So, early and precise diagnosis is critical. In this talk, we highlighted evidence-based diagnostic approaches using advanced multimodal imaging techniques, such as fundus autofluorescence, spectral-domain optical coherence tomography, and optical coherence tomography angiography (or OCTA). These tools are essential for assessing the disease stage, monitoring progression, and determining prognosis.

It's worth noting that very early changes in AMD tend to affect the rod photoreceptors actually more than the cones. A significant area of development is emerging treatments, particularly complement inhibitors. These injectable therapies work by inhibiting components of the complement cascade, a process that's been implicated in geographic atrophy pathogenesis.

We go through the various clinical trials that have been done.

Dr. Ramsey presented some data that he did on a population-based study looking at the incidence of wet AMD, as well as reported intraocular inflammation.

So, while these new management strategies are really exciting for the field and show the potential to develop even newer agents beyond these current drugs, we also reviewed management strategies including early intervention for low vision rehabilitation—covering aspects like magnification needs, lighting control, contrast enhancement, utilizing conventional devices, as well as newer ones.

Also, we’re going off what we know from the ongoing AREDS2 studies, looking at the role of micronutrient or vitamin supplementation and how that can contribute to slowing geographic atrophy progression toward the macula. We also looked at some of the post-hoc analyses that have recently been published by the AREDS group.

The field of non-neovascular dry AMD and geographic atrophy treatment is rapidly advancing. So, really having a grasp on the diagnostic methods and the therapeutic options—by critically evaluating the literature and looking at comprehensive management strategies between optometry and ophthalmology—I think is crucial for optimizing patient care and enhancing the independence of our patients. OM