WIO 2026: Dr. Amine on distance as a top risk for GA retention

Distance from clinic emerged as the strongest predictor of loss to follow-up among patients receiving complement inhibitor therapy for geographic atrophy (GA) secondary to age-related macular degeneration, according to research presented in a poster by Reem Amine, MD, postdoctoral research fellow with Duke Eye Center in Durham, North Carolina, at the Women in Ophthalmology (WIO) 2026 Summer Symposium.

Amine’s study examined factors associated with loss to follow-up in patients on complement inhibitor therapy for GA, including treatment burden, distance to clinic, and socioeconomic variables. The finding that stood out most, she said, was the relationship between distance and outcomes: every 10-mile increase in distance from clinic was associated with a 14% increase in the odds of being lost to follow-up.

Amine said the result was not entirely surprising, given how much GA treatment depends on repeated visits and injections over time, but it reinforces that “when we think about the success of complement inhibition, we can’t think of efficacy and safety only”—access and sustainability of treatment matter just as much.

A challenge distinct to GA

When asked how much of the loss-to-follow-up problem is specific to GA versus barriers seen across chronic retinal disease generally, Amine said it is both. Distance and demographic factors are common across chronic retinal conditions, she said, but GA adds an additional layer of difficulty because its treatment benefit is less tangible than that of anti-VEGF therapy. Patients may not perceive a difference at the vision level, which can lead them to question the value of continuing frequent injections. Amine emphasized that expectation-setting and counseling at the start of treatment are particularly important for GA patients, alongside addressing practical barriers like transportation.

A practical fix practices can implement now

Amine’s suggested near-term change for retina practices: a standardized retention check at treatment initiation to flag patients at higher risk for loss to follow-up—particularly those living farther from clinic or facing access barriers—for proactive scheduling reminders. “The key here is to intervene before the patient gets lost to follow-up,” she said, “rather than trying to recover them after we lose them.” Her data did not capture specific factors like transportation, work flexibility, or caregiver support, which she flagged as directions for future prospective study of social determinants.

Looking ahead: AI in retina practice

Asked what she would like to see addressed going forward, Amine pointed to incorporating more AI tools into everyday retina practice, an area she is exploring in other ongoing projects. As retina care advances rapidly alongside new gene therapies and imaging technologies, she said AI could aid earlier disease detection, progression monitoring, personalized treatment, and identifying patients at risk of falling out of care.