Hi, I'm Mohammad Aqil, a third-year medical student at the Oakland University William Beaumont School of Medicine. I'm here at ARVO 2026, presenting our study on complement inhibition in eyes with coexisting geographic atrophy and neovascular AMD. This work was done with my mentors, Dr. Viet Chau and Dr. Jeremy Wolfe, at Associated Retinal Consultants in Royal Oak, Michigan.

Geographic atrophy and neovascular AMD frequently coexist in the same eye, and these are patients you see all the time in a busy retina clinic. But the pivotal complement inhibitor trials, OAKS, DERBY, GATHER1, and GATHER2, largely excluded eyes with active neovascular AMD. So when retina specialists are deciding whether to layer on complement inhibition on top of chronic anti-VEGF therapy, they're often doing it without much evidence, and that's the gap our study tries to fill. We did a single center retrospective cohort of 210 eyes that initiated either pegcetacoplan or avacincaptad pegol for geographic atrophy between January 2023 and December 2024, all with coexisting neovascular AMD.

First, visual acuity remained clinically stable. The mean change was about two ETDRS letters over six months, which is well below the thresholds for clinically meaningful change. Second, central subfield thickness was unchanged within OCT measurement noise, so there was no significant anatomic destabilization seen. Third, and this was the most interesting finding, the mean anti-VEGF injection interval modestly extended rather than shortened by about eight days. So adding complement inhibition on top of anti-VEGF therapy did not appear to destabilize disease control or push patients towards more frequent injections.

On safety, adverse events occurred in about 3% of eyes, with no cases of retinal vasculitis or endophthalmitis within six months, and this is consistent with what the post-marketing literature has described. We also ran an exploratory analysis, and found that longer pre-complement inhibition anti-VEGF intervals were associated with higher odds of post-initiation intensification of treatment. This is a potential signal for closer monitoring after starting complement inhibition, though it needs external validation before clinical use.

Looking ahead, the natural next steps for this work are a longer follow-up of 12 and 24 months, multicenter validation, and ultimately, a prospective registry of these patients on complement inhibition. Our hope is that work like this helps fill an evidence gap that the pivotal trials weren't designed to address. Thank you for watching.