CLINICAL ENDPOINTS FOR THE STUDY OF GEOGRAPHIC ATROPHY SECONDARY TO AGE-RELATED MACULAR DEGENERATION

Overview

Journal Retina

Date 2016 Sep 23

PMID 27652913

Citations 49

Authors

Srinivas R Sadda

Usha Chakravarthy

David G Birch

Giovanni Staurenghi

Erin C Henry

Christopher Brittain

Affiliations

Soon will be listed here.

Abstract

Purpose: To summarize the recent literature describing the application of modern technologies in the study of patients with geographic atrophy (GA) secondary to age-related macular degeneration.

Methods: Review of the literature describing the terms and definitions used to describe GA, imaging modalities used to capture and measure GA, and the tests of visual function and functional deficits that occur in patients with GA.

Results: In this paper, we describe the evolution of the definitions used to describe GA. We compare imaging modalities used in the characterization of GA, report on the sensitivity and specificity of the techniques where data exist, and describe the correlations between these various modes of capturing the presence of GA. We review the functional tests that have been used in patients with GA, and critically examine their ability to detect and quantify visual deficits.

Conclusion: Ophthalmologists and retina specialists now have a wide range of assessments available for the functional and anatomic characterization of GA in patients with age-related macular degeneration. To date, studies have been limited by their unimodal approach, and we recommend that future studies of GA use multimodal imaging. We also suggest strategies for the optimal functional testing of patients with GA.

Citing Articles

Structure-Function Relationships in Geographic Atrophy Based on Mesopic Microperimetry, Fundus Autofluorescence, and Optical Coherence Tomography.

Mukherjee S, Arunachalam T, Duic C, Abraham M, Orndahl C, Menezes S Transl Vis Sci Technol. 2025; 14(2):7.

PMID: 39908134 PMC: 11806430. DOI: 10.1167/tvst.14.2.7.

Deep Learning to Predict the Future Growth of Geographic Atrophy from Fundus Autofluorescence.

Salvi A, Cluceru J, Gao S, Rabe C, Schiffman C, Yang Q Ophthalmol Sci. 2025; 5(2):100635.

PMID: 39758130 PMC: 11699103. DOI: 10.1016/j.xops.2024.100635.

Intravitreal Administration of Avacincaptad Pegol in a Nonhuman Primate Model of Dry Age-Related Macular Degeneration.

Fujii R, Matsushita M, Itani Y, Hama A, Natsume T, Takamatsu H Pharmacol Res Perspect. 2024; 13(1):e70052.

PMID: 39722646 PMC: 11669843. DOI: 10.1002/prp2.70052.

Characterizing Patient Perceptions of Living with Geographic Atrophy: The Global Geographic Atrophy Insights Survey.

Bakri S, Brinkmann C, Mulvey A, Steinberg K, Katz R, Vatsyayan P Clin Ophthalmol. 2024; 18:3725-3737.

PMID: 39691308 PMC: 11651066. DOI: 10.2147/OPTH.S488559.

Efficacy and safety of complement inhibitors in patients with geographic atrophy associated with age-related macular degeneration: a network meta-analysis of randomized controlled trials.

Wang H, Zheng J, Zhang Q, Tian Z, Sun Y, Zhu T Front Pharmacol. 2024; 15:1410172.

PMID: 39600369 PMC: 11589381. DOI: 10.3389/fphar.2024.1410172.

References

Niemeijer M, van Ginneken B, Russell S, Suttorp-Schulten M, Abramoff M . Automated detection and differentiation of drusen, exudates, and cotton-wool spots in digital color fundus photographs for diabetic retinopathy diagnosis. Invest Ophthalmol Vis Sci. 2007; 48(5):2260-7. PMC: 2739583. DOI: 10.1167/iovs.06-0996. View

Alten F, Heiduschka P, Clemens C, Eter N . Multifocal electroretinography in eyes with reticular pseudodrusen. Invest Ophthalmol Vis Sci. 2012; 53(10):6263-70. DOI: 10.1167/iovs.12-10094. View

. The Age-Related Eye Disease Study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the Age-Related Eye Disease Study Report Number 6. Am J Ophthalmol. 2001; 132(5):668-81. DOI: 10.1016/s0002-9394(01)01218-1. View

Schatz H, McDonald H . Atrophic macular degeneration. Rate of spread of geographic atrophy and visual loss. Ophthalmology. 1989; 96(10):1541-51. DOI: 10.1016/s0161-6420(89)32694-7. View

Mangione C, Lee P, Gutierrez P, Spritzer K, Berry S, Hays R . Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001; 119(7):1050-8. DOI: 10.1001/archopht.119.7.1050. View

Hazel C, Petre K, Armstrong R, Benson M, Frost N . Visual function and subjective quality of life compared in subjects with acquired macular disease. Invest Ophthalmol Vis Sci. 2000; 41(6):1309-15. View

Maguire P, Vine A . Geographic atrophy of the retinal pigment epithelium. Am J Ophthalmol. 1986; 102(5):621-5. DOI: 10.1016/0002-9394(86)90535-0. View

Kleinman M, Ambati J . Complement Activation and Inhibition in Retinal Diseases. Dev Ophthalmol. 2015; 55:46-56. PMC: 5502539. DOI: 10.1159/000431141. View

Rapantzikos K, Zervakis M, Balas K . Detection and segmentation of drusen deposits on human retina: potential in the diagnosis of age-related macular degeneration. Med Image Anal. 2002; 7(1):95-108. DOI: 10.1016/s1361-8415(02)00093-2. View

10.

Kawa M, Machalinska A, Roginska D, Machalinski B . Complement system in pathogenesis of AMD: dual player in degeneration and protection of retinal tissue. J Immunol Res. 2014; 2014:483960. PMC: 4168147. DOI: 10.1155/2014/483960. View

11.

Klein R, Klein B, Jensen S, Meuer S . The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology. 1997; 104(1):7-21. DOI: 10.1016/s0161-6420(97)30368-6. View

12.

Marsiglia M, Boddu S, Bearelly S, Xu L, Breaux Jr B, Freund K . Association between geographic atrophy progression and reticular pseudodrusen in eyes with dry age-related macular degeneration. Invest Ophthalmol Vis Sci. 2013; 54(12):7362-9. PMC: 3823546. DOI: 10.1167/iovs.12-11073. View

13.

. Risk factors for choroidal neovascularization in the second eye of patients with juxtafoveal or subfoveal choroidal neovascularization secondary to age-related macular degeneration. Macular Photocoagulation Study Group. Arch Ophthalmol. 1997; 115(6):741-7. DOI: 10.1001/archopht.1997.01100150743009. View

14.

Hunter J, Morgan J, Merigan W, Sliney D, Sparrow J, Williams D . The susceptibility of the retina to photochemical damage from visible light. Prog Retin Eye Res. 2011; 31(1):28-42. PMC: 3242847. DOI: 10.1016/j.preteyeres.2011.11.001. View

15.

Wu Z, Ayton L, Guymer R, Luu C . Low-luminance visual acuity and microperimetry in age-related macular degeneration. Ophthalmology. 2014; 121(8):1612-9. DOI: 10.1016/j.ophtha.2014.02.005. View

16.

Sunness J, Ziegler M, Applegate C . Issues in quantifying atrophic macular disease using retinal autofluorescence. Retina. 2006; 26(6):666-72. DOI: 10.1097/01.iae.0000236472.56195.e9. View

17.

Hohn A, Grune T . Lipofuscin: formation, effects and role of macroautophagy. Redox Biol. 2013; 1:140-4. PMC: 3757681. DOI: 10.1016/j.redox.2013.01.006. View

18.

Schmitz-Valckenberg S, Bindewald-Wittich A, Dolar-Szczasny J, Dreyhaupt J, Wolf S, Scholl H . Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD. Invest Ophthalmol Vis Sci. 2006; 47(6):2648-54. DOI: 10.1167/iovs.05-0892. View

19.

Querques G, Massamba N, Srour M, Boulanger E, Georges A, Souied E . Impact of reticular pseudodrusen on macular function. Retina. 2013; 34(2):321-9. DOI: 10.1097/IAE.0b013e3182993df1. View

20.

Kovach J, Schwartz S, Agarwal A, Brantley M, Pan S, Haines J . The Relationship Between Reticular Pseudodrusen and Severity of AMD. Ophthalmology. 2015; 123(4):921-3. PMC: 4808363. DOI: 10.1016/j.ophtha.2015.10.036. View