Clinical Scorecard: Imaging and Treatments for Dry Age-Related Macular Degeneration

At a Glance

Key Highlights

• Early and precise diagnosis using multimodal imaging techniques such as fundus autofluorescence, spectral-domain OCT, and OCT angiography is critical.
• Emerging treatments include injectable complement inhibitors targeting the complement cascade implicated in geographic atrophy.
• Management strategies encompass low vision rehabilitation, micronutrient supplementation per AREDS2 findings, and ongoing evaluation of novel therapies.

Guideline-Based Recommendations

Diagnosis

• Utilize advanced multimodal imaging (fundus autofluorescence, spectral-domain OCT, OCTA) to assess disease stage and monitor progression.
• Recognize early rod photoreceptor changes as an indicator of disease onset.

Management

• Consider complement inhibitor injections for geographic atrophy based on clinical trial evidence.
• Implement low vision rehabilitation including magnification, lighting control, and contrast enhancement.
• Recommend micronutrient or vitamin supplementation guided by AREDS2 study results to slow progression.

Monitoring & Follow-up

• Regular imaging follow-up to track disease progression and treatment response.
• Monitor for potential intraocular inflammation associated with new injectable therapies.

Risks

• Potential intraocular inflammation linked to complement inhibitor treatments.
• Progression to advanced vision loss if diagnosis and intervention are delayed.

Patient & Prescribing Data

Patients with dry AMD and geographic atrophy, particularly older adults at risk of vision loss

Complement inhibitors show promise but require monitoring for inflammation; micronutrient supplementation supports slowing progression; low vision aids enhance patient independence.

Clinical Best Practices

• Integrate multimodal imaging routinely for early detection and staging of dry AMD.
• Collaborate between optometry and ophthalmology for comprehensive patient management.
• Educate patients on the importance of micronutrient supplementation and low vision rehabilitation.
• Critically evaluate emerging clinical trial data to inform treatment decisions.

References

• 2025 American Academy of Optometry Annual Meeting Presentation
• AREDS2 Study on Micronutrient Supplementation