Grading Geography Atrophy

 

Geographic atrophy (GA), the advanced form of dry AMD, causes slow but permanent vision loss. New drugs such as pegcetacoplan and avacincaptad pegol can slow the growth of GA damage, but they do not stop vision from getting worse, and they require frequent eye injections with risks and high cost. Because of this, doctors often struggle to decide when treatment is truly worthwhile.

Researchers at Wake Forest University created a prototype decision tool called Atrophy Advisor to help. The tool estimates how long it will take for GA to reach the fovea (the center of vision) by measuring the distance from current lesions to the fovea. It also uses lifespan calculators to estimate how many years of vision a patient might need to preserve. By combining these two factors, it helps doctors judge whether treatment would meaningfully protect vision during a patient’s lifetime.

In their study of 50 GA patients (median age 78), lesions moved closer to the fovea at an average rate of 122µm per year. Lifespan calculators estimated about 11–12 more years of life, and differences between lifespan models changed treatment recommendations in a small number of cases. The authors say better, eye-specific lifespan tools are needed.

Overall, Atrophy Advisor is still experimental, but it offers a promising framework to personalize GA treatment decisions. Future improvements may include larger studies, standardized imaging, and machine-learning models to refine predictions.