Geographic Atrophy (GA)
Geographic Atrophy (GA) represents an advanced, irreversible form of dry age-related macular degeneration (dAMD), a leading cause of vision loss in older adults. Characterized by the progressive death of photoreceptors in the macula, the part of our retina responsible for our central vision. GA leads to the development of expanding “blind spots” in the central visual field. This gradual loss of function can significantly impact quality of life and the ability to read, drive, and recognize faces.
A Fundus Autofluorescence image captured on an Optos Ultra-Widefield (UWF) camera. This image sequence shows the progression of the GA lesions centrally (notice the dark spots expand and coalesce together). The image progression was documented on a singlepatient from 2022-2024.
For many years, the landscape of management for GA was characterized by a lack of specific therapy options. While preventative strategies such as AREDS2 vitamin supplements, smoking cessation, and a healthy lifestyle are important, there was no intervention to try and slow down the progression of atrophic lesions once they had formed.
Years of intensive research into the underlying pathophysiology of AMD and GA revealed the crucial role of the complement system in the progression of the disease.
The complement system is a part of the body’s innate immune system. Further research revealed that chronic over-activation and dysregulation of the complement cascade within the eye contribute significantly to the inflammation and cellular damage that drives GA progression. This understanding paved the way for a new approach to trying to treat dAMD – target specific components of this cascade to decrease the damaging immune response. In 2023, two new treatments were approved by the FDA to slow the progression of GA lesions – Syfovre and Izervay. Both medications are injected intravitreally (through the white part of the eye) once per month or every other month and showed the ability to slow down GA progression by 20% or more.
It is crucial to understand that these medications do not reverse existing damage or restore vision loss; they are a treatment to try and preserve the remaining visual function. Though these treatments are a monumental step forward in further understanding and managing this progressive disease, no treatment comes without risk. Though these risks are rare, it should be mentioned to all patients considering treatment so that they can make an informed decision regarding their eye care.
GA most commonly starts in the fovea, the region next to the center of the retina. Image by of Suber Huang, MD, MBA, FASRS. Retina Image Bank; Image 6296. American Society of Retina Specialists.
The arrival of these first-generation GA treatments marks a hopeful new era. Researchers are working diligently at exploring other targets in the complement system, alternative delivery methods, gene therapies, and potential combination approaches. While a cure remains elusive, the ability to finally intervene and slow the course of GA offers a tangible benefit and renewed optimism for the millions of patients affected by dAMD. Early diagnosis through regular, comprehensive eye exams remains critical to identifying GA.
At River City Retina Consultants, we strive to provide compassionate and personalized care to your patients. Offering the most up-to-date and effective treatments. We are happy to evaluate and share in the care of your patients with Geographic Atropy (GA).
Spotlight
Pneumatic Retinopexy is a procedure used to repair a detached retina and restore vision. Unlike other surgical treatments for retinal detachment, it is performed in an office setting rather than an operating room. This minimally invasive approach offers the advantage of potentially repairing the detachment immediately, without the need to wait for surgery center or operating room availability.
Dr. Perez was the first physician in our practice to perform pneumatic retinopexy, demonstrating our commitment to offering advanced and timely care.
Dr. Perez joined River City Retina Consultants in 2024 and is the only native Spanish-speaking retina specialist in the state.
With Louisville being home to one of the fastest-growing Cuban populations in the United States, we take great pride in having physicians and staff who can communicate directly with Spanish-speaking patients about their eye health, treatment options, and care in a way that is clear, comfortable, and truly understood.
