Geographic atrophy

诊断

Eye doctors often use several tests to find geographic atrophy and check how it changes over time.

• Visual acuity and reading tests: These tests check how well you see letters and words.
• Dilated fundus exam: The eye doctor puts drops in the eyes that make the pupils bigger and then shines a bright light into the eyes. The exam helps find changes that could affect your vision. You get your test results right after the exam.
• Optical coherence tomography, also called OCT: This painless scan of the retina shows details of each layer. It helps find thinning or damage. Results are usually available on the same day.
• Fundus autofluorescence, also called FAF: A special camera takes pictures of the back of the eye to look for damaged cells. These images are available right away.
• Amsler grid: This chart shows black lines forming small squares with a black dot in the center. When you have geographic atrophy, you may start to see blurry spots near the center of the grid. You can use it at home to help find changes in your vision.

治疗

Until 2023, there were no approved treatments for geographic atrophy. Now, the U.S. Food and Drug Administration, also called the FDA, has approved two medicines for treatment. These are called avacincaptad pegol (Izervay) and pegcetacoplan (Syfovre). The medicines block proteins that might damage the retina. However, there is no lasting cure for geographic atrophy.

These treatments are given as shots in the eye. The shots generally are given every 1 to 2 months. Talk with your eye doctor to see if these medicines may be an option for you.

Side effects of the treatment can include:

• Redness or pain at the injection site.
• Small dark blobs called floaters in the vision.
• Risk of infection inside the eye, called endophthalmitis.
• Risk of new blood vessel growth inside the eye, called wet macular degeneration.
• Risk of inflammation inside the eye, called intraocular inflammation, vasculitis inflammation or vasculitis.

Gene therapy is being studied as a treatment for geographic atrophy.

Your eye doctor likely will ask you to have regular follow-up exams. This is to track any changes in your vision.

Your eye doctor also may ask you to use an Amsler grid. This test helps you check for changes in your vision at home. Using an Amsler grid each week can help you notice changes such as new blank spots or lines that look wavy.

生活方式与家庭疗法

Vision loss from geographic atrophy can affect everyday life. These tips may help:

• Use brighter lights for reading and detailed work.
• Try magnifying tools or electronic readers with larger text.
• Ask your eye doctor whether high-powered reading glasses or telemicroscopic glasses might help.
• Label items in large or bold letters.
• Stay active with exercise and hobbies you enjoy.
• Stay social by joining support groups, in person or online.
• Prepare your home with good lighting, clear walkways and color-contrasting steps. Remove items such as rugs that might increase your risk of falling.
• Ask your eye doctor for referrals to low-vision services.

Talk with your eye doctor about other ways to stay independent.

准备您的预约

You likely will need an eye exam and testing to check for geographic atrophy. Make an appointment with a doctor who specializes in eye care — an optometrist or an ophthalmologist.

What you can do

Before your appointment:

• When you make the appointment, ask if you need to do anything to prepare.
• List any symptoms you're experiencing, including those that may not seem related to your vision changes.
• List all medicines, vitamins and supplements you take, including the doses.
• Ask a family member or friend to go with you. You may need someone to drive or be with you after your appointment.
• List questions to ask your eye doctor.

For geographic atrophy, questions to ask include:

• How advanced is my condition?
• Will I experience more vision loss? If so, how quickly will that happen?
• Can my condition be treated?
• How should I monitor my vision for changes?
• What changes in my symptoms should I call you about?
• What low vision aids might help me?
• Are there any lifestyle changes I can make to protect my vision?

What to expect from your doctor

Your eye doctor is likely to ask you a few questions, such as:

• When did you first notice your vision condition?
• Does the condition affect one or both eyes?
• Do you have trouble seeing things near to you, at a distance or both?
• Do you smoke or did you used to smoke? If so, how much?
• What types of foods do you eat?
• Do you have other medical conditions, such as high cholesterol, high blood pressure or diabetes?
• Do you have a family history of macular degeneration?