Readiness of optometrists in the management of geographic atrophy: a survey of optometrists in Australia.

Abstract

Clinical relevance: Geographic atrophy is a leading cause of severe vision loss and is estimated to affect around 100,000 people in Australia alone. This survey is topical for clinical optometrists as the first treatment for geographic atrophy has just been approved by the Australian Therapeutics Goods Administration and may soon become available in Australia.

Background: Considering that treatments for geographic atrophy secondary to age-related macular degeneration are likely imminent, a survey of Australian optometrists was conducted to gauge their readiness in caring for people with geographic atrophy.

Methods: The Royal Australian and New Zealand College of Ophthalmologists age-related macular degeneration referral guidelines working group determined 26 survey questions relating to management of geographic atrophy. Strength of agreement questions utilised a 5-point Likert scale. Optometrists answered anonymously during January to March 2024.

Results: There were 101 survey responses. Almost all (97%) respondents have access to colour fundus photography, three-quarters (74%) to optical coherence tomography, and almost half (44%) to fundus autofluorescence. Almost all (97%) see patients with GA regularly, with 73% seeing at least two geographic atrophy patients per month and the majority reviewing them every 6 months. Around half were confident in differentiating geographic atrophy from inherited retinal disease (49%) and confident in identifying early signs of atrophy (44%). Around half (46%) nominated that they would refer over 50% of their current geographic atrophy patients to ophthalmology for assessment of their suitability for new treatments. Eighty-three percent would refer a patient with good vision (6/12 or better) to initiate treatment to save encroachment on the fovea. Respondents were keen to receive more education about diagnosis (88%) and new treatments (93%).

Conclusion: Optometrists are preparing for changes in the clinical management of geographic atrophy and are keen to receive further education to ensure optimal patient-centric care as new treatments become available.