Regulatory approval of the first two therapeutic substances for the management of geographic atrophy (GA) secondary to age-related macular degeneration has been a major breakthrough. The authors explored the issue surrounding the lack of agreed therapeutic standards and diagnostic tools as key challenges. As the GA biomarkers are subclinical, advance imaging techniques are required. In contrast to fundus autofluorescence, optical coherence tomography (OCT) provides high-resolution visualisation of neurosensory layers, including photoreceptors, and other features that are beyond the scope of clinical assessment. The authors highlight the current evidence surrounding artificial intelligence-based methodology enhancing identification and quantification of clinically relevant GA-related sub-phenotypes. The authors argue for the introduction of OCT-based biomarkers to provide novel insight into the mechanisms of disease progression and therapies, moving beyond the limitations of conventional descriptive assessment.
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