Izervay (Avacincaptad Pegol) for Geographic Atrophy: Uses & Action

Podcast: Play in new window | Download | Embed

Subscribe: Apple Podcasts | Spotify | Amazon Music | Android | RSS

Key Takeaways

• What is Izervay used for: Izervay (avacincaptad pegol) is FDA-approved to slow the progression of geographic atrophy secondary to age-related macular degeneration, preserving vision for longer.
• Izervay mechanism of action: By inhibiting complement protein C5, Izervay helps reduce retinal cell death, offering patients a proactive way to protect their remaining vision.
• Teamwork matters: Optometrist–ophthalmologist collaboration ensures timely detection, clear patient education, and consistent messaging, leading to better treatment adherence and outcomes.

In Partnership with Astellas

Geographic atrophy (GA) is advancing into everyday optometric practice—and the timing of what happens after detection matters. In this Four-Eyed Professor episode, Chris Lievens, OD, MS, FAAO, welcomes retina specialist Jessica Haynes, OD, FAAO, to explore how geographic atrophy should be identified, how to talk about it, and when to act. From referral timing to patient counseling around Izervay (avacincaptad pegol) and other complement inhibitor therapies, they share a clinic-tested approach that helps clinicians protect vision now while preparing patients for what’s next.

Why Naming “Geographic Atrophy” Matters

Geographic atrophy awareness is growing thanks to consumer campaigns, but many patients still arrive unfamiliar with the term. Dr. Haynes recommends using the exact diagnosis—geographic atrophy—instead of only euphemisms like “blind spots” or “degeneration.” Naming the disease validates the condition, provides patients with language to research resources, and ensures consistency when transitioning to ophthalmology referral.

Action in clinic: Use “geographic atrophy” in your first two sentences. Then add a plain-language anchor: “GA is an advanced stage of dry macular degeneration where patches of retinal tissue thin and stop working.”

First-visit game plan: Educate, Don’t Overwhelm

The first appointment often determines long-term adherence. Dr. Haynes’s approach:

1. Define GA simply. Frame it as accelerated age-related thinning of retinal tissue that creates “bald patches” in vision.
2. Cover modifiable factors. Nutrition, systemic health, and visual habits remain relevant for retinal wellness.
3. Introduce treatment without pressure. Outline that therapies such as Izervay exist to slow progression, not reverse damage. When asked what is Izervay used for, explain it is FDA-approved to slow the progression of geographic atrophy secondary to age-related macular degeneration.
4. Normalize a paced decision. Most patients won’t decide on treatment the same day. Send home a concise handout and reputable links, then schedule a follow-up solely for questions.

Actionable script:
“Today is about understanding geographic atrophy, how we monitor it, and what options exist to protect vision over time. I’ll give you a short guide to review at home. We’ll regroup soon to discuss questions and next steps.”

Shifting From “Wait and See” to “Detect and Act”

The profession has long labeled GA as “slowly progressive,” breeding a habit to monitor without momentum. Two traps stand out:

• Recency bias: Seeing a patient every few months can make interval changes feel small, while year-over-year imaging shows significant progression.
• Novelty discomfort: When therapy is new, confidence in counseling can lag, encouraging passive follow-up.

Implementation pearls

• Compare today’s OCT and FAF with images 12–24 months prior.
• If you’d consider therapy “soon,” refer now. Let ophthalmology confirm candidacy while the patient starts absorbing information.

Talking Treatments: Set Expectations, Preserve Trust

For Izervay (avacincaptad pegol) and other complement inhibitor therapy options, precision in messaging is critical:

• What it does: Slows future GA growth to protect vision longer.
• What it does not do: Restore lost vision or make today’s vision sharper.
• What it requires: Ongoing, indefinite therapy—typically monthly or every other month—plus adherence to follow-up.

Izervay mechanism of action
Izervay works as a complement C5 inhibitor. By blocking part of the overactive complement pathway, it reduces the inflammatory cascade thought to accelerate retinal cell death in GA. Simplifying the science helps patients see why monthly or bimonthly injections matter for protecting their remaining vision.

Optometrist–Ophthalmologist teamwork
When optometrists and ophthalmologists collaborate effectively, patients benefit most. If a patient appears hesitant, the optometrist can schedule a brief “expectations visit” after the ophthalmology consultation to revisit goals and logistics. This coordinated approach ensures patients feel supported across both providers, reinforces consistent messaging, and improves treatment adherence with therapies like Izervay.

The Timing Question: When to Start and Why “Now”

When patients ask, “What’s the best time to begin?” Dr. Haynes offers a memorable principle:
If the system has been “faulty” for years, the ideal time to inhibit the pathway would have been long ago; the next best time is now.

Why timely action matters:

• Geographic atrophy progression is cumulative; lost tissue does not return.
• Trial data show the benefit of Izervay diverges over time—the longer therapy is continued, the greater the separation from natural history.

Clinical takeaway: If imaging and function suggest candidacy, a proactive referral and decision pathway today beats reconsidering after another 6–12 months of enlargement.

Breaking the “Wait and See” Habit: Team Workflow

Geographic Atrophy Action Pathway (Clinic SOP)

1. Name it early: Use “geographic atrophy” in the plan.
2. Show it visually: Compare today’s images with past scans.
3. Educate concisely: Provide a one-page GA explainer + Izervay overview.
4. Fast-track ophthalmology referral: Send immediately if candidacy is possible.
5. Book two visits today: (a) Ophthalmology consult; (b) 2–4 week optometrist “questions visit.”
6. Expectation script in chart: “Goal = protect vision longer; therapy does not improve vision today.”
7. Adherence supports: Note transportation, care-partner, and reminders.
8. Annual reality check: Re-display baseline vs. current imaging to reinforce the “why.”

Finding the Balance: Urgency Without Fear

Dr. Haynes emphasizes authentic care over perfect phrasing. Patients sense intent. To avoid tipping into fear:

• Lead with partnership: “We’ll decide together.”
• Invite values: “How does this plan fit your goals and routines?”
• Respect informed refusal: Declining therapy is reasonable if aligned with patient values—just ensure the “no” isn’t rooted in fear.
• Debrief misses: If a conversation overshoots into anxiety, acknowledge it, reset, and continue at the patient’s pace.

Actionable language to borrow

• “We cannot make vision sharper today, but we can protect vision for longer.”
• “Let’s plan a short visit just for your questions before you decide.”
• “Many patients find Izervay injections become a routine part of protecting their sight.”

Youtube Video goes here

For optometrists, owning the first conversation on geographic atrophy and building a quick, respectful path to ophthalmology referral is now core care. When clinicians name GA clearly, show progression visually, set expectations for Izervay (avacincaptad pegol) therapy, and pace decisions without pressure, more patients choose—and stick with—treatments that protect function over time. The right time to act is the patient in your chair today.