Combining Ophthalmic Images With EHR Data Provides an Enhanced Understanding of the Geographic Atrophy Patient Journey


Durga Borkar, MD, MMCi Verana Health

Geographic atrophy (GA) is a condition in which large central areas of a person’s retina cease to function. GA impacts between 1 million to 2 million Americans and can cause irreversible vision loss and even blindness as the areas of the retina that are experiencing cell death expand. Approximately 1% of Americans have the atrophic form in at least one eye, but this increases to 3.5% in patients older than 75 and to nearly 25% in people over age 90. GA accounts for approximately 20% of legal blindness in the U.S.

In addition to age, risk factors for GA include race (Caucasians have the highest rate of GA), family history of advanced macular degeneration, active or former smoking status, and use of thyroid hormones or antacids. Comorbid ophthalmic conditions include cataract, prior cataract surgery, and GA in the fellow eye, while coronary heart disease and hypercholesterolemia are associated systemic conditions.

There is just one recently FDA-approved GA treatment available with more under investigation.  This means that, until now, patients have been managing their condition solely through lifestyle modifications and annual/semiannual visits to a retina specialist, other ophthalmologist, or optometrist. 

The value of high-quality images

For life sciences companies seeking to better understand the progression of the disease, de-identified, quality real-world data (RWD) from electronic health records (EHRs) can provide valuable insights. With the addition of high-quality linked ophthalmic images, a more complete view of how GA progresses in patients will emerge, which can help provide a stronger foundation to advance this research. 

That’s why Verana Health’s new Qdata® Geographic Atrophy holds so much potential by helping to provide a comprehensive clinical view of RWD from almost 350,000 de-identified GA patients. The launch of this module makes Verana Health a leader in identifying GA diagnosis from both EHRs and images for life sciences companies. 

The module’s availability is extremely timely since the first treatment is now available and more are on the horizon. Physicians have been using their patients’ images in their practices to diagnose and monitor GA, but having insights from a broad data set with linked images offers the possibility of being able to better diagnose GA earlier in the progression of the disease. The module will also help track the uptake and treatment patterns and outcomes as treatments become available, providing life sciences companies and physicians with insights into disease progression and treatment regimens to help determine what will work best for each patient. 

Verana Health’s clinical-imaging dataset includes more than 3.5 million unique ocular images from more than 320,000 unique visits by more than 72,000 unique de-identified patients with ongoing expansion of the dataset planned. Qdata Geographic Atrophy offers life sciences companies real-world images taken in physicians’ offices outside of a research setting. This is important since most clinical trials rely on images from academic medical centers that meet narrow criteria. Insights gained from these images will enable the development of algorithms that can be broadly applied to enhance clinical research. Leveraging our curation of data from unstructured EHR notes and ophthalmic images, Qdata Geographic Atrophy provides key variables to help life sciences companies understand the GA patient journey. Variables such as diagnosis and visual acuity (VA), can be derived from clinician notes and diagnosis codes, as well as the ability to understand subfoveal involvement, which is a derived variable and confirmed through images. The information will help provide a more complete view of disease severity and progression.

GA module use cases

Qdata Geographic Atrophy enhances the ability of life sciences companies to identify practices that treat patients with specific GA profiles based on EHR data. This could lead to improved trial design and optimization, site selection and patient recruitment. 

For health economics and outcomes research (HEOR) and medical affairs, the high-quality GA images help provide valuable real-world information about the natural history of the condition, treatment patterns and outcomes, postmarketing efficacy, and comparative effectiveness as more therapies come to market. Also, by highlighting basic clinical characteristics and demographics of the patients receiving specific approved GA treatments, the images in the new Qdata module can generate market insights and support sales forecasting for pharmaceutical companies.

Combining ophthalmic images with EHR data from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) will help life sciences companies gain an unprecedented view into the GA patient journey. One of the largest specialty society clinical data registries in medicine, the IRIS Registry contains ophthalmic records for more than 78 million patients covering roughly a decade. Verana Health is responsible for data curation, EHR integration, analytics, practice support, and quality reporting for clinicians contributing to the IRIS Registry. 

In the case of GA, the old cliché really is true: a picture is truly worth a thousand words. Ophthalmic images, such as OCT and fundus autofluorescence, capture the size, characteristics and progression of a lesion and can help life sciences companies understand whether certain ocular comorbidities could worsen vision. The expansion of this dataset is already underway, and it will continue to grow with the ongoing addition of new images.  

Adding images to IRIS Registry EHR data creates a dynamic RWD set to help life sciences companies generate data-driven insights that can help accelerate innovations in ophthalmology to improve eye care and quality of life for patients with GA and other ocular conditions.

Verana Health Logo

Let's Accelerate Research Together

To learn more about Verana Health, please fill out the information below and our team will follow up with you as soon as possible.