Clinical Scorecard: Rethinking EMAP and Its Relationship to AMD

At a Glance

Key Highlights

• EMAP was first described in 2009 as a potentially distinct macular dystrophy.
• Reported features include vertical macular atrophy, pseudodrusen-like deposits, and negative genetic testing.
• The speaker describes presumed basal laminar deposits as a feature shared with AMD and suggests EMAP may be a late atrophic AMD variant or subtype.
• EMAP has similarities to the diffuse-trickling pattern of GA.
• The speaker says prior trials that included diffuse-trickling GA should be reevaluated because some participants may have had EMAP.

Guideline-Based Recommendations

Diagnosis

Management

• The speaker says prior trials that included diffuse-trickling GA should be reevaluated because a subset of participants may have had EMAP.

Monitoring & Follow-up

Risks

• The speaker raises the possibility that some diffuse-trickling GA participants in prior trials had EMAP, which may affect how the results are viewed.

Patient & Prescribing Data

Patients with EMAP or diffuse-trickling GA; the article does not provide prescribing or dosing data.

Anticomplement therapies were studied in AMD-related GA trials. The speaker notes evidence of complement involvement in EMAP and calls for reevaluation of trials that included diffuse-trickling GA.

Clinical Best Practices

Related Resources & Content

• Hamel CP, Meunier I, Arndt C, et al. Extensive macular atrophy with pseudodrusen-like appearance: a new clinical entity. Am J Ophthalmol. 2009;147(4):609-620. doi:10.1016/j.ajo.2008.10.022.
• Holz FG, Bindewald-Wittich A, Fleckenstein M, et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration. Am J Ophthalmol. 2007;143(3):463-472. doi:10.1016/j.ajo.2006.11.041.