Significant vision loss in AMD often precedes detectable foveal changes

In patients with geographic atrophy (GA) due to non-exudative age-related macular degeneration (AMD), significant visual acuity (VA) loss can occur before detectable foveal involvement, according to a study.

The retrospective, longitudinal cohort study included 80 eyes from 60 patients with non-neovascular AMD, observed over an average period of 60 months using blue-light fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT).

Results showed a steady decline in VA, with an average monthly decrease of 0.010 LogMAR. The onset of foveal involvement significantly worsened this decline, leading to an additional loss of 0.15 LogMAR. Rapid VA decline was often detected months before visible foveal damage, particularly in patients with specific FAF patterns and smaller baseline GA lesions.

The researchers concluded that these finding suggests there is an opportunity for early intervention to slow down the progression of visual impairment and underscores the need for personalized treatment strategies based on specific retinal characteristics.

Reference
Cicinelli MV, Barlocci E, Rissotto F, et al. The Discrepancy Between Visual Acuity Decline and Foveal Involvement in Geographic Atrophy. Ophthalmol Retina. 2024;S2468-6530(24)00361-0. doi: 10.1016/j.oret.2024.07.025. Epub ahead of print. PMID: 39121994.