Identifying geographic atrophy

Abstract

Purpose of reviewAge-related macular degeneration (AMD) is one of the leading causes of blindness and can progress to geographic atrophy (GA) in late stages of disease. This review article highlights recent literature which assists in the accurate and timely identification of GA, and monitoring of GA progression. Recent findingsTechnology for diagnosing and monitoring GA has made significant advances in recent years, particularly regarding the use of optical coherence tomography (OCT). Identification of imaging features which may herald the development of GA or its progression is critical. Deep learning applications for OCT in AMD have shown promising growth over the past several years, but more prospective studies are needed to demonstrate generalizability and clinical utility.

Prevalence of geographic atrophy in Nordic countries and number of patients potentially eligible for intravitreal complement inhibitor treatment: A systematic review with meta‐analyses and forecasting study

“…A limitation is that all studies in this review rely on diagnostics based on fundus photography or fundoscopy. This older method is in contrast to the macular optical coherence tomography (OCT), which provides a significant leap in the diagnostic certainty for AMD and GA (Clevenger & Rachitskaya, 2023; Crincoli et al, 2022). In line with this, our review highlights another important aspect, which is that newer epidemiological studies with multimodal imaging or at least using OCT are needed to better understand the epidemiology of the clinical phenomena of our daily practice, which are largely based on routine access to multimodal imaging and at least an OCT (Clevenger & Rachitskaya, 2023; Crincoli et al, 2022).…”

Geographic atrophy: pathophysiology and current therapeutic strategies

“…The images obtained by OCT can characterize the retina layers in the form of hypo- or hyper-reflective bands. OCT is a sensitive examining tool for GA evaluation as it provides a detailed characterization of retinal layers ( 3 ). This method can be used to visualize drusen deposits, choroidal neovascularization, detachment of RPE, and subretinal fluid ( 21 , 30 ).…”

“…The onset of the disease is characterized by the formation of lipid-rich extracellular deposits called drusen particles ( 2 ). AMD affects 28 million people worldwide and causes loss of vision in the population aged over 50 ( 3 ). The Clinical AMD staging system ( 4 ), based on the size of drusen particles, as identified by the color fundus photography, classifies the disease into the following grades: Grade 1, which has no drusen or few drusen deposits with sizes less than 63 µm.…”

“…GA or dry/non-exudative AMD with or without foveal involvement is an advanced form of AMD, which affects over 8 million people globally, and it is known to cause permanent visual impairment ( 3 , 5 ). The term “geographic” is used because the atrophic areas typically appear as well-defined, irregularly shaped lesions that may resemble the outlines of a map.…”

“…Especially, GA incidence was shown to increase four-fold every ten years from the ages 50 to 80 in the European population ( 8 , 9 ). GA affects the outermost layers of the retina, leading to a progressive decline in retinal pigment epithelial cells (RPE), photoreceptor cells, and reduced vessel density in the choriocapillaris ( 3 , 10 ). The foveal region is located at the center of the macula, it comprises a high density of cone photoreceptors and is responsible for central and color vision.…”