Learn about the advanced form of dry age-related macular degeneration, called geographic atrophy.
Some patients with age-related macular degeneration (AMD) will develop geographic atrophy (GA), which refers to regions of the retina where cells waste away and die (atrophy). Sometimes these regions of atrophy look like a map to the doctor who is examining the retina, hence the term geographic atrophy. The regions of atrophy result in a blind spot in the visual field.
Wet AMD and Geographic Atrophy
Patients with wet age-related macular degeneration, (wet AMD) will sometimes have GA before, during, or after they have the wet form of AMD; they are not mutually exclusive. GA can affect one or both eyes, and a patient with GA in one eye is more likely to develop it in the other.
GA can be diagnosed by an ophthalmologist during a dilated exam and/or with retinal imaging. In a dilated exam, GA appears as a patch of retina that’s missing its dark melanin pigment. Imaging techniques including retinal color photographs, optical coherence tomography (OCT), or autofluorescence photographs can also be used to detect GA. Read more about the eye exam for macular degeneration.
There is currently no proven treatment for GA. Patients can benefit from increased lighting, magnification and low vision devices that help with reading. Some patients may prefer an implantable miniature telescope, which is surgically inserted into the eye in place of the lens. It can help certain carefully selected patients with near or distance vision by magnifying images.
There are several ongoing clinical trials designed to slow or prevent expansion of GA, or to replace dead vision cells. Genentech/Roche has a Phase III trial with lampalizumab, which is injected into the eye once a month. This drug inhibits an inflammatory pathway called the complement cascade, known to play a role in AMD. In one Phase III trial, lampalizumab failed to slow the rate of expansion of geographic atrophy. Results of a second Phase III trial are expected in November, 2017
The Geographic Atrophy Lipoic Acid (GALA) clinical trial is testing whether a once-per-day antioxidant/iron chelator pill can slow the growth of GA.
Cell replacement is also being tested for GA. A few patients have received stem cell treatments . The most promising of these have the cells grown on plastic sheets, which are surgically placed under the retina and unrolled into position. The cells have been well-tolerated and can survive in the recipient’s eye for at least a year.
GA robs sight, but advances in low vision therapy (by specially trained optometrists) and implantable miniature telescopes can help patients adapt to their diminished retinal function. New treatments already in clinical trials or being tested in National Institutes of Health (NIH) and/or foundation-funded labs—like those supported by Macular Degeneration Research, a BrightFocus Foundation program— bring hope for improved vision on the horizon.
- Wet Macular Degeneration (Article and Video)
- Dry Macular Degeneration (Article and Video)
- Why is My Doctor Always Talking About “Drusen”? (Article)
- Update on Dry Age-Related Macular Degeneration (Article)
- How to Use the Amsler Grid (Article)
- The Implantable Miniature Telescope for Macular Degeneration (Article)
- The Eye Exam for Macular Degeneration (Article)
- Search for Clinical Trials: Antidote.me or ClinicalTrials.gov (Clinical Trial Search)
This content was last updated on: Thursday, September 28, 2017
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