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Ophthalmology Management

Article

Rapid Developments in Geographic Atrophy

Current and emerging GA treatments offer hope to affected patients and demonstrate ongoing innovation in this field.

By: Sidra Zafar, MD, Sunir Garg, MD, FACS, FASRS
Ophthalmology Management July 1, 2025 Vol 29, Issue July/August 2025 Page(s): 14, 15, 16, 17

Clinical Report: Rapid Developments in Geographic Atrophy

Overview

Recent advancements in treatments for geographic atrophy (GA) offer new hope for patients, with FDA approvals for pegcetacoplan and avacincaptad pegol. These therapies demonstrate significant reductions in GA lesion growth, although none currently prevent or reverse the condition.

Background

Geographic atrophy is a severe manifestation of age-related macular degeneration (AMD), a leading cause of blindness affecting millions globally. As the population ages, the prevalence of AMD and GA is expected to rise, making effective treatment options critical. Understanding the progression and management of GA is essential for preserving vision and improving patient outcomes.

Data Highlights

TreatmentLesion Growth ReductionStudy Duration
Pegcetacoplan (monthly)21%12 months
Pegcetacoplan (every other month)16%12 months
Pegcetacoplan (monthly, GALE study)35%36 months
Pegcetacoplan (every other month, GALE study)24%36 months

Key Findings

  • GA accounts for approximately 20% of legal blindness cases in the US.
  • Pegcetacoplan and avacincaptad pegol are the first FDA-approved treatments for GA.
  • Pegcetacoplan showed a 21% reduction in GA lesion growth at 12 months in the OAKS trial.
  • Photobiomodulation therapy improved visual acuity and reduced GA development.
  • AREDS and AREDS2 vitamins did not affect overall GA growth but slowed proximal growth by 35-36%.

Clinical Implications

Clinicians should consider the emerging treatment options for GA, particularly pegcetacoplan and avacincaptad pegol, which have shown promising results in slowing disease progression. Early detection and proactive management are essential to optimize patient outcomes and preserve vision.

Conclusion

The landscape of geographic atrophy treatment is evolving, with new therapies providing hope for patients. Continued research and clinical vigilance are necessary to maximize the benefits of these advancements.

References

  1. Optometric Management, 2025 -- Geographic Atrophy: Early Detection and Patient Awareness Matters
  2. Optometric Management, 2025 -- A New Frontier
  3. Optometric Management, 2025 -- Importance of Early Identification of Geographic Atrophy and Treatment Recommendations
  4. Guideline Central -- AAO Age-Related Macular Degeneration Guideline Summary
  5. PubMed -- Pegcetacoplan Treatment for Geographic Atrophy in Age-Related Macular Degeneration Over 36 Months
  6. optometric management — Detecting Diagnostic and Prognostic Biomarkers of Geographic Atrophy
  7. Detecting Diagnostic and Prognostic Biomarkers of Geographic Atrophy
  8. AAO Age-Related Macular Degeneration Guideline Summary - Guideline Central
  9. Pegcetacoplan Treatment for Geographic Atrophy in Age-Related Macular Degeneration Over 36 Months: Data From OAKS, DERBY, and GALE - PubMed
  10. The effect of complement C3 or C5 inhibition on geographic atrophy secondary to age-related macular degeneration: A living systematic review and meta-analysis - PubMed