Geographic atrophy growth rate predicts long-term visual acuity loss

A secondary analysis of data from the Age-Related Eye Disease Studies (AREDS and AREDS2) found that the progression of geographic atrophy (GA) in age-related macular degeneration is strongly linked to a decline in best-corrected visual acuity (BCVA) over 4 years.

The study included 1,351 eyes from 994 participants, with 594 eyes having a full 4-year BCVA follow-up. Researchers found that eyes with GA lesions involving or within 1 mm of the foveal center and a baseline BCVA of ≥40 letters (approximately 20/160 Snellen) were more likely to experience significant vision loss. Faster GA progression was also associated with greater BCVA decline.

In contrast, eyes with baseline BCVA <40 letters or GA lesions >1 mm from the foveal center showed minimal vision loss over time. These findings suggest that patients with fovea-involving GA may benefit the most from treatments aimed at slowing disease progression, potentially influencing future clinical trial designs and management strategies.

Reference
Shen LL, Kaiser PK, Liu J, et al. Determinants of Four-Year Visual Acuity Loss in Geographic Atrophy – An Analysis of AREDS and AREDS2. Ophthalmology. 2025;S0161-6420(25)00082-X. doi: 10.1016/j.ophtha.2025.01.028. Epub ahead of print. PMID: 39921001.