At the 2025 Controversies in Modern Eye Care conference, Dilsher Dhoot, MD, FASRS, of California Retina Consultants shared his forward-looking perspective on developments in retinal disease management, highlighting both recent breakthroughs and promising innovations on the horizon. The Controversies in Modern Eye Care meeting took place on May 4, 2025, in Los Angeles, California.
A turning point in retinal therapeutics
Key takeaways for optometrists:
- GA management is evolving: New therapies exist, and more are coming with enhanced durability and efficacy.
- AI and imaging biomarkers are redefining personalized care and patient tracking in retinal diseases.
- Optometrists are key gatekeepers: Early detection and referral can significantly impact outcomes.
- Empower and reassure patients: Communicate the hope that current and future treatments bring.
- Refer when in doubt: Diagnostic clarity and therapeutic potential often justify early retina consultation.
“We’re in a golden era of retina,” Dhoot began, referencing a wave of recent FDA approvals and a pipeline rich with potential. He expressed particular enthusiasm about gene therapy and tyrosine kinase inhibitors, which offer new hope for patients needing longer treatment durability. These therapies, he noted, are "just around the corner" and could significantly extend treatment intervals compared to existing regimens.
The evolution in geographic atrophy management
A major focus of Dhoot’s remarks was geographic atrophy (GA). “We haven’t traditionally had therapy for GA, but now we do,” he noted, referring to the two FDA-approved treatments that have emerged in recent years. While these agents can slow atrophy progression, he emphasized that this is just the beginning.
“The pipeline will include more durable agents, and possibly more effective ones,” he said. He also stressed the growing role of artificial intelligence in identifying patients who may benefit most from current and future treatments. AI-driven imaging and biomarker identification are already showing promise in personalizing care and improving outcomes.
Optometry’s pivotal role in retinal health
Dhoot praised optometrists for their role in early detection and referral. “You do a great job identifying these patients,” he said, emphasizing that timely referral doesn’t signify imminent vision loss. “Being sent to retina is not a sentence to blindness.”
He encouraged optometrists to reassure patients about intravitreal injections, noting that they’re less daunting than they sound. “The eye is a very easy place to inject,” he said, and with current therapies, patients can retain—and sometimes even improve—vision.
Referral thresholds and collaborative care
Dhoot urged optometrists to consider a low threshold for referral, particularly when diagnostic uncertainty exists or interventions are available. “For myself, if I’m not sure, I refer,” he said. While conditions like intermediate AMD or mild NPDR can sometimes be monitored, he stressed the importance of access to advanced imaging and clear communication between providers.
As the field of retina rapidly advances, collaboration between optometry and retina specialists will remain crucial in delivering optimal patient care.
