US Retina Specialists' Preferences for Geographic Atrophy Treatment.

Area of Science:

• Ophthalmology
• Retinal Diseases
• Age-Related Macular Degeneration

Background:

• Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD).
• Current treatments for GA focus on complement inhibition, with others in development.
• Understanding retina specialists' (RS) treatment preferences is crucial for optimizing patient care.

Purpose of the Study:

• To quantitatively assess retina specialists' preferences for geographic atrophy (GA) treatments.
• To explore how GA treatment characteristics influence RS preferences and trade-offs.
• To determine if these preferences vary based on patient profiles.

Main Methods:

• A best-best discrete choice experiment (BB-DCE) involving 166 US-based retina specialists.
• Participants evaluated hypothetical treatment options based on lesion growth reduction, risks (uveitis, wet AMD progression, vasculitis), and injection frequency.
• Patient profiles were defined by GA lesion location and visual acuity.

Main Results:

• Lesion growth rate reduction was the most significant factor (47%) in RS decision-making.
• Reducing the risk of progression to wet AMD (15% to 1%) had the largest impact among risks (~20%).
• Retina specialists preferred one-time treatments over monthly injections and showed increased risk tolerance for patients with foveal-threatening GA.

Conclusions:

• Retina specialists prioritize efficacy (lesion growth reduction) over treatment risks and injection frequency for GA.
• Risk tolerance is higher for treatments with greater efficacy and for patients with foveal-threatening GA lesions.
• A one-time treatment option may be preferred over monthly injections if efficacy is comparable, even with slightly higher risks.