Hear + Now: Geographic Atrophy Symptoms, Progression, and Treatment

Geographic atrophy (GA) is a chronic eye condition in which the cells in the retina slowly break down and die, which leads to poor retinal function and vision loss. A retina that has GA sometimes looks like a topographical map to eye doctors examining the eye, hence the name.^1,2

In this audio digest, MacularDegeneration.net takes a closer look at the available research and patient experiences of geographic atrophy and its symptoms and treatment. You can find a transcript of this audio digest below.

This audio digest was generated with the assistance of an AI tool and has been reviewed by our Editorial Team. This information is provided for general knowledge and is not a substitute for professional medical advice.

Transcript

Speaker 1: Today we're exploring geographic atrophy, or GA – it's the advanced form of dry age-related macular degeneration that's affecting millions worldwide. We'll cover what GA means, how it progresses, and, you know, the latest treatments that are available.

Speaker 2: Yeah, thanks, Adrian. So, geographic atrophy is the advanced stage of dry age-related macular degeneration. And about 20 percent of people with AMD eventually develop GA, which represents the progression from, like, early and intermediate stages to advanced AMD.

Speaker 1: Right, and as GA progresses, patients experience, you know, specific changes. Um, one common early sign is blurred vision — and actually, many of our Health Leaders describe constantly asking their eye doctor for stronger glasses, not realizing that stronger lenses couldn't solve this particular problem.

Speaker 2: Mm-hmm, and another symptom is fading colors – you know, Health Leaders tell us this is particularly noticeable with traffic signals, where, like, yellow becomes much harder to distinguish, making driving increasingly difficult. Um, there's also distorted vision, where straight lines appear wavy – so, telephone poles look bent, or car headlights create this, you know, confusing ghost vision effect.

Speaker 1: Yeah, and one really dangerous symptom is losing depth perception. Walking down stairs becomes treacherous, and we often hear about serious falls with broken bones.

Speaker 2: Right, so in geographic atrophy, damage spreads and photoreceptor cells die, creating blank spots in vision. Key symptoms include less sharp vision, difficulty with reading and driving, dark spots in central vision, and problems seeing in low light.

Speaker 1: Absolutely. And, you know, when patients progress to geographic atrophy specifically, those blank spots become more pronounced, and existing symptoms typically worsen. Many Health Leaders report they must constantly focus on the ground when walking outdoors to avoid falls.

Speaker 1: But there's one aspect of advanced vision loss that many people haven't heard of – Charles Bonnet syndrome.

Speaker 2: Yes – Charles Bonnet syndrome isn't well-known. But it can occur in people with significant vision loss and results in visual hallucinations. And patients often don't realize what's happening at first. Common experiences include, like, seeing bright lights when closing their eyes at night, spinning or geometric patterns, or even seeing people who aren't actually there. One Health Leader described frequently seeing her husband get up and leave the bedroom at night, only to find he was still sound asleep beside her. She also described seeing bold letters and numbers appearing with her eyes closed. And these visual hallucinations can be quite startling if patients don't know they're related to vision loss.

Speaker 1: Yeah, exactly. Charles Bonnet syndrome occurs when the brain tries to, you know, make sense of reduced visual input by creating its own images.

Speaker 1: And it's crucial for patients and families to understand that these are not, um, psychiatric hallucinations, but rather the brain's attempt to fill in the gaps left by vision loss.

Speaker 1: This knowledge can be incredibly reassuring for people experiencing these symptoms.

Speaker 2: Right, so GA progresses differently for everyone, primarily affecting central vision. And, um, age is the biggest risk factor.

Speaker 1: Yeah, the average diagnosis for GA is 79. However, people can lower their risk by, you know, not smoking, managing diabetes and blood pressure, protecting their eyes with sunglasses, and, um, maintaining healthy nutrition and exercise.

Speaker 2: Oh, exciting news – we now have FDA-approved treatments for GA! Two medications, Syfovre and Izervay, can slow disease progression through eye injections.

Speaker 2: While they don't reverse damage, they may prevent vision from worsening as quickly. Treatment decisions involve, you know, several factors. Many people in their 80s decide not to start treatment. Um, transportation is a major consideration since patients need regular appointments and many can no longer drive safely.

Speaker 1: Right, and the biggest concern is, um, potential side effects, particularly developing wet macular degeneration. So some decide the risk isn't worth it, especially with slow progression. However, patients with rapid progression often choose treatment, typically starting with injections twice a month.

Speaker 2: That's right. And results have been encouraging. One Health Leader saw her vision improve, with her scans showing no GA progression. While not all patients see improvement, many benefit from, like, slowed progression.

Speaker 1: Yeah, these treatments represent a major breakthrough, though, you know, results vary. They slow progression rather than restore vision. So the decision involves weighing the benefits against the risks.

Speaker 2: So if you're dealing with geographic atrophy, remember there are now treatment options available. Early detection matters. Work with your eye care team, stay informed, and don't hesitate to advocate for your vision health.

The information discussed in this audio digest was originally published in the following articles:

• Progress Report: My Geographic Atrophy Treatment
• Geographic Atrophy Progression and Outlook
• Charles Bonnet Syndrome and Geographic Atrophy