Geographic Atrophy

In early dry macular degeneration, cells in the macula begin to waste away and die (atrophy), and parts of central vision become blurry. This may be difficult to notice at first, especially if the other eye is healthy, which can often hide the problems of the affected eye. Some people may find that they need more light to read but otherwise may not notice problems with their vision.

As dry macular degeneration slowly progresses, the blurring worsens and increases in size. Some permanent blind spots (called scotomas) in the visual field may develop. The person may begin to have trouble telling the difference between similar colors, or shades of the same color.

Symptoms of geographic atrophy include:

• Difficulty reading in dim lighting
• Poor night vision
• Central vision loss, including difficulty seeing faces, cooking, driving, etc.
• Black spot in central vision
• Slower reading speed; one or several letters in a word appear “missing”
• Difficulty distinguishing between different shades
• Trouble with glare

The first treatments for geographic atrophy were approved by the U.S. Food and Drug Administration in 2023. The first, Syfovre, was approved in February 2023, followed by Izervay in September 2023. Both treatments slow the progression of the disease by targeting inflammation in the complement pathway system in the eye.

Macular Degeneration Research, a BrightFocus Foundation program, funds innovative research into new drugs and ways to manage and treat this complex form of AMD.

Despite its severity, macular degeneration usually doesn’t affect both eyes equally. Many people find they can adapt and function by making the most of their remaining vision; some find new ways to accomplish their daily activities through vision rehabilitation. Certified low-vision therapists can help you make the most of your remaining vision with special vision aids and devices such as magnifiers, and occupational therapists can help you do everyday tasks and chores, such as setting up your kitchen, bathroom, lighting, etc., in new ways. These two types of low-vision evaluations are typically reimbursable by private insurers and Medicare.

Your initial visits to these specialists are not just a one-time experience. These doctors will help you adapt as your vision continues to change. With this type of professional assistance, you can learn to develop new ways of doing the things you love as your vision changes and maintain your independence and quality of life.

To preserve remaining vision, it’s important to protect your eye health. Here are a few steps to take:

• If you are a smoker, stop right away.
• Eat a healthy diet rich in antioxidants and omega-3 such as fish, whole grains, and dark leafy greens.
• Exercise regularly.
• Ask your eye doctor if the AREDS2 formula of vitamins and minerals would be beneficial.
• Get regular, dilated eye exams as recommended by your doctor, and use an Amsler grid to monitor your vision.
• Request a referral for a low-vision therapist or occupational therapist in your area. Listen to a conversation with a low-vision specialist about how these professionals can help.

In 2022, BrightFocus partnered with Apellis Pharmaceuticals to launch a Harris Poll on a global survey revealing the emotional burden and impact on independence caused by geographic atrophy. It found that:

• Nearly seven in ten geographic atrophy patients believe the impact on their independence and quality of life due to their visual field decline is worse than they expected.
• Most patients feel the disease negatively affects aspects of everyday life like the ability to read, drive, and travel.
• Three out of four patients attributed their vision loss to a natural part of aging before their geographic atrophy diagnosis, reinforcing the opportunity for broad disease education.