Dry age-related macular degeneration (AMD) may progress to geographic atrophy (GA), leading to vision loss in some people. Pegcetacoplan (Syfovre) is a newly approved medication that can help slow the progression.

AMD is a slow, progressive disease. In some people, AMD will progress to GA, an advanced stage of the condition that affects an estimated 1 million people in the United States. The disease can eventually lead to total loss of central vision.

There are two types of AMD: wet and dry. Dry is more common. In dry AMD, damage to the macula’s light-sensitive cells causes visual disturbances, which often start as blurry vision and eventually progress to loss of central vision. The macula sits near the center of the retina at the back of the eye, which is why AMD typically affects central vision.

In 2023, the Food and Drug Administration (FDA) approved pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay) as the first medications to help treat GA. These medications may improve the outcome for people living with GA.

This article explores commonly asked questions about the outlook for GA.

GA is an advanced stage of dry AMD, which progresses slowly over time. Doctors and researchers often refer to the damaged area of the macula as a lesion. The progression rate is how quickly the lesion grows.

The authors of a 2017 research review noted that previous studies had indicated a growth rate between 0.53 and 2.6 square millimeters (mm2) per year. Similarly, some research from 2018 found an average GA lesion enlargement rate of around 2 mm2 per year.

However, a 2021 study that included 171 people reported that GA enlargement rates varied widely, from 0.02 to 4.05 mm2 per year, with an average of 1.09 mm2 per year.

Several factors affect how quickly the condition progresses. These include:

  • initial size of the lesion
  • number of lesions present
  • location of the lesion or lesions
  • high levels of hyper autofluorescence found on fundus autofluorescence, a noninvasive imaging test of the eye
  • status of the other eye

Environmental, demographic, and genetic factors may also play a role.

GA progresses over time, causing permanent vision changes. Experts generally view the outlook as unfavorable due to the extensive loss of visual acuity.

Since GA does not affect the areas of the retina outside the macula, it does not usually affect peripheral vision. Total vision loss does not usually occur unless there are other serious eye issues or complications from treatment.

In 2023, the FDA approved pegcetacoplan and avacincaptad pegol as the first medications to treat GA.

People receive these medications via injections into the eye monthly or every other month. The medications work by calming the immune response to help prevent damage to retinal cells.

In clinical trials, the drugs slowed the development of GA by 14–20% over 1 year. However, these drugs cannot restore lost vision or improve a person’s vision.

Researchers continue to investigate new medications in clinical trials.

Maintaining healthy lifestyle habits can also be beneficial for people with GA. These may include:

  • stopping smoking, if applicable
  • eating a healthy, balanced diet full of fruits and vegetables
  • participating in regular exercise
  • taking supplements or vitamins
  • wearing sunglasses

A person may also want to consider the use of visual aids. This can include:

  • using brighter lights
  • reading large-print publications
  • using magnifying devices
  • using specialized computers, tablets, or programs that can help read applications

A person should discuss the possibility of injectable medications with their ophthalmologist and make appropriate lifestyle adjustments where necessary.

GA is a late stage development of dry AMD.

An eye doctor may be able to identify GA by examining the eye. An early sign of GA is the development of drusen — deposits on the retina that are made up of proteins, fats, and other debris and appear yellowish on a dilated eye exam.

A person may first notice changes in their ability to read or drive. They may see straight lines as wavy and experience changes in contrast sensitivity. As the disease progresses, a person may notice a decrease in visual acuity.

Experts state that when GA affects the fovea — a central area of the retina where acuity is highest — it can lead to a rapid decline in a person’s ability to see.

In a 2021 study, researchers noted that GA is an increasing issue in an aging population. In their study of 171 people, the mean age of onset was 82.6 years.

According to a 2023 article, the average age of a person with GA is 79 years. From the age of 50 years, the number of people with GA quadruples every 10 years, from 0.16% at age 60 to 2.91% at age 80.

GA is a progressive late stage of dry AMD that causes permanent loss of visual acuity.

For years, doctors suggested lifestyle changes, including stopping smoking, exercising regularly, and eating a healthy diet. In 2023, the FDA approved the first medication for GA that can help slow the progression and potentially shrink lesions.

Researchers are currently investigating additional treatments that may be available in the coming years once approved.