Atrophic macular degeneration, or geographic atrophy, is an advanced stage of dry age-related macular degeneration. Destruction of the cells — known as atrophy — in the retina can eventually lead to dim or blind spots in vision.
Age-related macular degeneration affects the macula, the central portion of the retina that enables people to see. Over time, this can cause blurry or wavy vision.
Typically, there are three stages of age-related macular degeneration, and atrophy can occur in the later stages. Vision loss in relation to atrophic macular degeneration can be gradual and takes several years. However, people generally lose vision in one eye before the other.
This article reviews the causes of atrophic macular degeneration, its symptoms, risk factors, diagnosis, treatment options, and prevention.
The three stages of macular degeneration
- Early dry age-related macular degeneration: People in this stage do not usually experience any symptoms.
- Intermediate dry age-related macular degeneration: While some people may not have symptoms during this stage, others may experience blurred vision and difficulty seeing in low light conditions.
- Late wet or dry age-related macular degeneration: People may notice black spots in their vision, the colors may not look as bright as before, and they can also experience blurred vision.
The symptoms a person with atrophic macular degeneration experiences can vary. A person may not develop any symptoms in the early stages of this condition until the atrophic macular degeneration progresses.
The symptoms of atrophic macular degeneration can affect one or both eyes. They may include:
- a dark or dim spot in the center or near the center of vision
- reduced sharpness or clarity of vision
- difficulty seeing in the center of vision
- difficulty seeing in dim light
- difficulty seeing in front when doing activities such as driving, reading, or cooking
- washed-out or dull colors
- needing extra light to read
If a person notices any of these symptoms, they should contact their healthcare professional immediately.
A person with dry age-related macular degeneration should have regular checkups with a doctor to assess the progression of their condition.
People ages 50 years or over should also have a complete eye exam and repeat it every 1–2 years based on the doctor’s recommendations. During the examination, the doctor will examine visual acuity and the retina after dilating the pupils.
A person who notices any symptoms of atrophic macular degeneration should also immediately contact a healthcare professional for an appointment.
Learn more about the early signs of macular degeneration.
Age-related macular degeneration usually onsets in people who are 50 years of age or older. Two types of age-related macular degeneration exist: dry or wet.
Dry age-related macular degeneration accounts for 85–90% of total cases of age-related macular degeneration. In some people, this condition can eventually lead to atrophic macular degeneration.
Atrophic macular degeneration causes cells to die in some areas of the retina. Doctors refer to this process as atrophy.
Learn more about the differences between wet and dry macular degeneration.
Aging is the most significant risk factor for developing age-related macular degeneration. This condition has the potential to progress to atrophic macular degeneration.
In the United States, people of European descent also seem to carry a higher risk for atrophic macular degeneration than those of African American descent. The reason for this is unclear.
Other risk factors for atrophic macular degeneration include:
- light-colored eyes
- smoking
- diabetes
- heart disease
- family history of atrophic macular degeneration
- high blood pressure
- obesity
- high cholesterol
- eating a diet low in fruits and vegetables
- high exposure to sunlight throughout the person’s lifespan
When doctors suspect atrophic macular degeneration, they may recommend undergoing a series of tests to assess eye health. The tests may include:
- Fundus photograph: This consists of taking a picture of the retina. This enables making comparisons during future checkups.
- Optical coherence tomography: This exam provides a cross-sectional image of the eye. This can show loss of tissue, the presence of fluid under the retina, or if there is a thickening of the macula.
- Visual function tests: These can help the doctor assess any visual impairment that a person with atrophic macular degeneration may sustain.
The Food and Drug Administration (FDA) approved the first-ever treatments for atrophic macular degeneration in February 2023:
- Syfovre (pegcetacoplan): This is a monthly injection that may help slow the progression of atrophic macular degeneration by
18–22% over the course of 2 years. - Izervay (avacincaptad pegol): This is also a monthly injection that reduces the progression of atrophic macular degeneration by
27% over 1 year.
Other treatments
A person may reduce the risk of developing atrophic macular degeneration by lowering the risk of age-related macular degeneration. This
- quitting or avoiding smoking
- regularly practicing physical activity
- eating a healthy and balanced diet
- maintaining optimal cholesterol and blood pressure levels
Regular eye checkups with a doctor may also help diagnose any eye conditions in their early stages so a person can take the relevant precautions.
Atrophic macular degeneration is an advanced stage of dry age-related macular degeneration. This condition can slowly lead to vision loss. In its early stages, it may cause blurred vision, difficulty reading in low light conditions, and black spots in the center of vision.
People who notice any symptoms of atrophic macular degeneration should contact a doctor. This condition is more common in people ages 50 years or more. Doctors may recommend a yearly eye checkup to monitor for signs of the onset of this condition.
The FDA has approved two medications that may help slow the degeneration process of vision for people with atrophic macular degeneration.