Geographic Atrophy (GA) is the advanced form of dry AMD, a leading cause of significant vision loss worldwide.1,2
Progression to GA is a frequent outcome of wet or dry AMD.3-5
Geographic Atrophy (GA) progression is


Geographic Atrophy lesion growth animation Geographic Atrophy lesion growth animation Geographic Atrophy lesion growth animation Geographic Atrophy lesion growth animation


While lesion growth in GA may appear to proceed slowly, disease progression is often constant, and always irreversible.6-9

Of the 397 patients who developed central GA, the median time to foveal encroachment was only 2.5 years from diagnosis according to a prospective AREDS study (N=3640)7*

*The Age-related Eye Disease Study (AREDS) #26, a long-term, multicenter, prospective study examining progression of GA area in a cohort of 3640 patients with signs of early and more advanced forms of AMD.

Even before the fovea is lost to GA, lesion growth may already affect functional vision.6,10,11

Even before the fovea is lost to GA, lesion growth may already affect functional vision.6,10,11


Functional vision declines as lesions grow6,10,11

Functional vision declines as lesions grow6,10,11

BCVA=best-corrected visual acuity; GA=Geographic Atrophy; nAMD=neovascular age-related macular degeneration.

Images courtesy of David Eichenbaum, MD, Retina Vitreous Associates of Florida.

Eye lesion
Explore the pre-lesion
where complement overactivation is causing the next wave of destruction6,14

The complement system normally plays a pivotal role in the immune system’s defense against pathogens and abnormal cells.15 However, in patients with GA secondary to AMD, increased levels of complement activity have been found in the lesion and the area just outside of it—the pre-lesion.14,16 This overactivation of the complement system accelerates cell damage outside of the lesion, increasing the risk of GA lesion growth.6,14,17,18

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References: 1. Gehrs KM, Anderson DH, Johnson LV, Hageman GS. Age-related macular degeneration—emerging pathogenetic and therapeutic concepts. Ann Med. 2006;38(7):450-471. doi:10.1080/07853890600946724. 2. Fleckenstein M, Mitchell P, Freund B, et al. The progression of geographic atrophy secondary to age-related macular degeneration. Ophthalmology. 2018;125(3):369-390. doi:10.1016/j.ophtha.08.038. 3. van Lookeren Campagne M, LeCouter J, Yaspan BL, Ye W. Mechanisms of age-related macular degeneration and therapeutic opportunities. J Pathol. 2014;232(2):151-164. doi:10.1002/path.4266. 4. Chakravarthy U, Bailey CC, Scanlon PH, et al. Progression from early/intermediate to advanced forms of age-related macular degeneration in a large UK cohort: rates and risk factors. Ophthalmol Retina. 2020;4(7):662-672. doi:10.1016/j.oret.2020.01.012. 5. Rofagha S, Bhisitkul RB, Boyer DS, Sadda SR, Zhang K; SEVEN-UP Study Group. Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology. 2013;120(11):2292-2299. doi:10.1016/j.ophtha.2013.03.046. 6. Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, Henry EC, Brittain C. The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target. Retina. 2017;37(5):819-835. doi:10.1097/iae.0000000000001392. 7. Lindblad AS, Lloyd PC, Clemons TE, et al; Age-Related Eye Disease Study Research Group. Change in area of geographic atrophy in the age-related eye disease study: AREDS report number 26. Arch Ophthalmol. 2009;127(9):1168-1174. doi:10.1001/archophthalmol.2009.198. 8. Holz FG, Strauss EC, Schmitz-Valckenberg S, van Lookeren Campagne M. Geographic atrophy: clinical features and potential therapeutic approaches. Ophthalmology. 2014;121(5):1079-1091. doi:10.1016/j.ophtha.2013.11.023. 9. Sunness JS, Margalit E, Srikumaran D, et al. The long-term natural history of geographic atrophy from age-related macular degeneration: enlargement of atrophy and implications for interventional clinical trials. Ophthalmology. 2007;114(2):271-277. doi:10.1016/j.ophtha.2006.09.016. 10. Kimel M, Leidy NK, Tschosik E, et al. Functional reading independence (FRI) index: A new patient-reported outcome measure for patients with geographic atrophy. Invest Ophthalmol Vis Sci. 2016;57(14):6298-6304. doi:10.1167/iovs.16-20361. 11. Sadda SR, Chakravarthy U, Birch DG, Staurenghi G, Henry EC, Brittain C. Clinical endpoints for the study of geographic atrophy secondary to age-related macular degeneration. Retina. 2016;36(10):1806-1822. doi:10.1097/IAE.0000000000001283. 12. Heier JS, Pieramici D, Chakravarthy U, et al. Visual function decline resulting from geographic atrophy: results from the chroma and spectri phase 3 trials. Ophthalmol Retina. 2020;4(7):673-688. doi:10.1016/j.oret.2020.01.019. 13. Rahimy E. Evaluating geographic atrophy in real-world clinical practice: new findings from the IRIS registry. Presented at: American Academy of Ophthalmology Meeting; November 14, 2020; virtual meeting. 14. Katschke KJ Jr, Xi H, Cox C, et al. Classical and alternative complement activation on photoreceptor outer segments drives monocyte-dependent retinal atrophy. Sci Rep. 2018;8(1):7348. doi:10.1038/s41598-018-25557-8. 15. Merle NS, Church SE, Fremeaux-Bacchi V, Roumenina LT. Complement system part I - Molecular mechanisms of activation and regulation. Front Immunol. 2015;6:262. doi:10.3389/fimmu.2015.00262. 16. Smailhodzic D, Klaver CC, Klevering BJ, et al. Risk alleles in CFH and ARMS2 are independently associated with systemic complement activation in age-related macular degeneration. Ophthalmology. 2012;119(2):339-346. doi:10.1016/j.ophtha.2011.07.056. 17. Park DH, Connor KM, Lambris JD. The challenges and promise of complement therapeutics for ocular diseases. Front Immunol. 2019;10:1007. doi:10.3389/fimmu.2019.01007. 18. Yates JRW, Sepp T, Matharu BK, et al; Genetic Factors in AMD Study Group. Complement C3 variant and the risk of age-related macular degeneration. N Engl J Med. 2007;357(6):553-561. doi:10.1056/NEJMoa072618.