Advances in Treating Geographic Atrophy
For years, geographic atrophy (GA) — an advanced form of dry age-related macular degeneration (AMD) — was considered a condition we could monitor, but not meaningfully treat. Care was limited to recommending AREDS2 supplements when appropriate and counseling patients on strategies to adapt to vision loss as the disease progressed. Now, with the FDA approvals of pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay), clinicians have the first treatments shown to slow GA progression.
Understanding Geographic Atrophy
Geographic atrophy (GA) develops in approximately 30% of patients with dry age-related macular degeneration, when the retinal cells begin to break down and form areas of permanent damage.
In earlier stages of dry AMD, small yellow deposits of cellular debris called drusen can form beneath the retina, a small layer at the back of the eye that plays a critical role in vision. Over time, drusen can trigger an immune response that causes the surrounding retinal cells to die, creating patches of damaged tissue. When viewed through imaging, these regions of cell loss resemble islands on a geographic map, which is where the condition gets its name.
As the condition advances, these areas of atrophy spread toward the macula and fovea—the parts of the retina responsible for central and sharp, detailed vision. At this stage, vision loss often becomes more pronounced, with patients beginning to experience more noticeable symptoms, such as blind spots and increasing difficulty with everyday tasks.
New FDA-Approved Treatments for GA
Until recently, once GA developed, there were no treatments available to slow its progression. Recent FDA approvals have introduced the first therapies shown to do so. Both pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay) belong to a class of drugs known as complement inhibitors. Both drugs are administered as intravitreal injections, delivered directly into the eye, typically monthly or every other month. They work by interfering with the complement system, which is a part of the immune response that can become overactive in dry AMD and contribute to the retinal cell damage seen in GA. By calming this response, these treatments help slow the rate at which retinal cells are lost.
Early Intervention is Key
While these therapies are a meaningful advancement, they do not restore vision that has already been lost. However, regular eye exams can help your retina specialist detect GA early, before it significantly affects central vision. With timely intervention, patients may be able to preserve their existing vision and maintain independence for longer.
Research into new treatments for GA is ongoing, with emerging approaches focused on halting retinal degeneration or even restoring lost vision. While none are approved yet, the progress made over the last few years suggests that the options available to patients will continue to expand.
If you’ve been diagnosed with geographic atrophy or have been told you’re at risk for advanced AMD, connect with a retina specialist as soon as possible. At Northeast Wisconsin Retina Associates, our team brings extensive experience diagnosing and treating retinal diseases and has remained at the forefront of advances in retinal care, including the newest treatment options for GA. Contact us todayto schedule an appointment or learn more.