Characterizing Disease Burden and Progression of Geographic Atrophy Secondary to Age-Related Macular Degeneration

Abstract

At initial diagnosis, based on VA in the better-seeing eye, a high proportion of patients with bilateral GA were ineligible to drive and approximately 7% were eligible for UK blindness registration. The subsequent reduction in VA that occurred in the better-seeing eye would render a further two-thirds ineligible to drive. These findings emphasize the severity of the visual disability associated with GA secondary to AMD.

A Double-Masked, Randomized, Sham-Controlled, Single-Center Study With Photobiomodulation for the Treatment of Dry Age-Related Macular Degeneration

“…The published rate of progression to CNV was recently reported as 7.4% per patient-year. 30 None of the ocular AEs were considered related to the device by the principal investigator and common for the type of disease treated.…”

<p>Burden of Illness in Geographic Atrophy: A Study of Vision-Related Quality of Life and Health Care Resource Use</p>

“…Patients with GA had significantly lower scores (representing poorer functioning) in most of the NEI-VFQ-25 subscales, with near activities, distance activities, and driving being most impacted. The poor recorded VA, the high prevalence of foveal involvement, and the low number of patients who were still driving support previously reported visual function and NEI-VFQ-25 data in patients with GA. 9,11,12,20 Within the Mahalo phase 2 trial of intravitreal lampalizumab for the treatment of GA secondary to AMD, 27 patients exhibited low scores for the driving, near activities, distance activities, and general vision subscales, although these scores, as well as the composite score, were higher than in our study, respectively (driving, 30.9 vs 21.8; near activities, 48.4 vs 25.6; distance activities, 56.1 vs 26.4; general vision, 50.0 vs 45.9; composite score, 61.7 vs 53.1). 20 The poorer function seen in patients in our study is despite the greater GA severity in the Mahalo population; patients recruited into Mahalo had to have a GA lesion size of~1-7 DA at baseline, whereas 21% of worse-seeing eyes in our study had GA lesions of <1 DA.…”

“…One in 5 of the patients with GA were either registered as blind or undergoing the registration process, which supports previous findings from a UK EMR study in which 7.1% were eligible for blindness registration in the United Kingdom at diagnosis, with a further 16% being eligible as vision impairment increased over time (median time to outcome, 6.2 years). 12 However, it should be noted that the definition of legal blindness varies between countries in the Notes: a Patients were currently going through the process for blindness classification and/or registration process pending completion. b Information missing for 1 patient.…”

“…10,11 Data from a UK electronic medical record (EMR) study suggest that at the time of diagnosis, a high proportion (71%) of individuals already have visual impairment that is below the commonly used driving standard threshold (ie, ≤70 letters or Snellen 6/12 [20/40]). 12 These data illustrate the heavy burden placed on individuals with GA in terms of loss of mobility and independence. There are currently no approved interventions to prevent, reduce, or halt the progression of GA, and thus GA represents a significant unmet medical need.…”

“…13 However, there is sparse knowledge of the impact of GA on patients' QoL, as well as on society and health care resources, particularly indirect costs. 14,15 While it is accepted that GA has a negative impact on patients' QoL, society, and the health care system, 12,14 there is limited published evidence specific to GA to confirm this. 16,17 This may be due in part to the fact that GA was only granted a code in the US-specific International Classification of Diseases, 10th Revision, Clinical Modification system in 2017, and in the International Classification of Diseases, 11th Revision system used in the rest of the world in December 2018.…”