Atrophy Advisor: A Clinical Tool for Dry Macular Degeneration With Geographic Atrophy.

Area of Science:

• Ophthalmology
• Medical Informatics
• Gerontology

Background:

• Geographic atrophy (GA) is a leading cause of vision loss in age-related macular degeneration (AMD).
• Current treatment decisions for GA, particularly with complement factor inhibitors, can benefit from personalized prognostic tools.
• Integrating disease progression with patient lifespan estimates may refine clinical management strategies.

Purpose of the Study:

• To develop and evaluate Atrophy Advisor, a novel clinical decision tool.
• To combine geographic atrophy (GA) progression rates with personalized lifespan estimates.
• To assist clinicians in treatment considerations for dry age-related macular degeneration (AMD) with GA.

Main Methods:

• Retrospective cohort study of 50 patients with GA secondary to nonexudative AMD.
• Fundus images analyzed using ImageJ to measure GA edge-to-fovea distance over time.
• Lifespan estimates calculated using established algorithms and compared to observed outcomes.

Main Results:

• Median GA progression rate was 122 µm/y, with a significant relationship between initial distance and progression (P = .006).
• Atrophy Advisor provided lifespan estimates (11.0 years) comparable to other calculators (11.9 years).
• The tool influenced treatment guidance in 4% of cases, demonstrating its potential clinical utility.

Conclusions:

• Atrophy Advisor is a feasible tool for integrating GA progression and lifespan data for clinical decision-making.
• Significant variability in progression rates and lifespan predictions underscores the necessity of personalized treatment strategies.
• Further validation in larger, prospective studies is recommended to confirm the tool's efficacy and refine its application.