ARVO 2025: Post-hoc analysis on GATHER 2 clinical trial data

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Giullia Coradetti, MD:

Hi, I'm Giullia Coradetti, one of the scientists at Doheny Eye Institute. I'm very happy to be able to present my research at ARVO annual meeting here in Salt Lake City. This year, I'm presenting a poster on the aurora characterization using fundus autofluorescence. It is a post-hoc analysis based on the GATHER 2 clinical trial data for geographic atrophy and age-related macular degeneration. Aurora lesions were initially introduced by the CaM group, and have structural biomarkers on OCT and [are] considered as precursors of atrophy.

However, we know that aurora lesions can be characterized by different phenotypes, and the phenotypes of these lesions might be quite heterogeneous, and this heterogeneity is affecting the progression to atrophy, the aurora, which is the corresponding on OCT for geographic atrophy. So in this study, we aim to characterize aurora lesions on OCT using another modality, fundus autofluorescence, and we detected different patterns on fundus autofluorescence of aurora lesions going from no changes to not classified patterns to hyper autofluorescence, questionable, and decreased autofluorescence.

We assessed the FAF pattern at baseline and at each follow-up up to 18 months. And we found that the majority of FAF pattern associated with the aurora lesions at baseline were characterized by no changes or questionable decreased autofluorescence. We assessed which baseline FAF pattern at baseline aurora, baseline lesions, were mostly likely to progress to aurora within month 18. We found that the patterns most likely to progress to aurora, where hyper-reflect hyper autofluorescence, or questionable decrease autofluorescence, or definitely decreased autoluorescence. And this might this is very important, suggesting that we might need a more granular classification of aurora to improve our knowledge of the aurora phenotypes to detect a that subset of the population with aurora lesions with higher risk for progression to aurora, and this ultimately will help the design the optimization of the design of early intervention clinical trials. So these lesions are actually considered precursors of geographic atrophy. So it would particularly important to study aurora lesions for the fact that they're part of that stage of AMD called as intermediate AMD, so prior to development of geographic atrophy and prior to progression to late AMD. They could represent a very important target for early intervention clinical trials, prior to the irreversible vision loss, characterized by geographic atrophy. So this is a more exploratory study.

So we are at that stage where we actually would like to achieve a more granular classification of all the features in the intermediate AMD stage. And in this specific case, we studied aurora lesions, and we just our aim was to integrate the OCT-characterized definition of aurora lesions, implementing with the fundus autofluorescence, with the hope that we could achieve a more granular characterization of these lesions. Going forward, we we would like actually to implement with additional multi-modal imaging to better understand these particular features of dry AMD.