Geographic Atrophy (GA)
An advanced form of Dry Age-Related Macular Degeneration (Dry AMD) that causes the gradual and irreversible loss of retinal cells in the macula.
Understanding Geographic Atrophy
Geographic Atrophy (GA) is an advanced form of Dry Age-Related Macular Degeneration (Dry AMD) that causes the gradual and irreversible loss of retinal cells in the macula.
The macula is the central area of the retina responsible for detailed vision needed for activities such as reading, recognising faces, driving, and seeing fine detail. In Geographic Atrophy, areas of the retina become damaged and progressively degenerate, creating regions where the retinal tissue no longer functions normally.
The condition develops slowly over time and can lead to significant changes in central vision. Although peripheral vision is usually preserved, people living with GA may experience difficulties with independence, daily activities, and quality of life.
Historically, there have been limited treatment options for Geographic Atrophy. However, recent advances in retinal research have led to the development of new therapies aimed at slowing disease progression, marking an important milestone in the management of advanced Dry AMD.
Retina International works with people affected by macular diseases, patient organisations, researchers, clinicians, and partners worldwide to improve understanding of Geographic Atrophy, support access to emerging treatments, and ensure that the experiences of people living with vision loss inform research and healthcare decisions.
What is Geographic Atrophy?
Geographic Atrophy is an advanced stage of Dry Age-Related Macular Degeneration characterised by the progressive loss of retinal cells, including:
- Retinal pigment epithelial (RPE) cells
- Photoreceptor cells
- Supporting retinal structures
As these cells deteriorate, areas of retinal tissue become unable to function. These areas of damage are called atrophy, and when they expand across the macula they create geographic patterns—giving the condition its name.
The retina relies on a close relationship between photoreceptors and the RPE to maintain healthy vision. Damage to these structures disrupts the ability of the eye to capture and process visual information.
GA usually progresses gradually, but the rate of progression varies significantly between individuals.
Some people experience slow changes over many years, while others may develop more rapid enlargement of affected areas.
Over 50
Geographic Atrophy most commonly affects people over age 50, with risk increasing as people get older.
Central vision loss
GA can make reading, recognising faces, using digital devices, and other detailed tasks increasingly difficult.
Progresses gradually
The areas of retinal damage can slowly expand over time, but the rate of progression varies significantly between individuals.
How Geographic Atrophy can affect vision
Loss of central vision
As areas of the macula become damaged, people may experience difficulty with detailed tasks such as:
- Reading
- Recognising faces
- Using digital devices
- Performing close-up activities
Blurred vision
Central vision may become unclear or less sharp.
Blind spots (scotomas)
Areas of missing vision may develop in the centre of sight.
These blind spots may initially be subtle but can become more noticeable as GA progresses.
Reduced contrast sensitivity
People may find it harder to distinguish objects from their background, particularly in low-light conditions.
Difficulty adapting to changes in lighting
Adjusting between bright and dim environments may take longer.
Increased need for brighter lighting
People may require additional lighting for reading and everyday tasks.
Because GA typically develops gradually, regular eye examinations are important to detect changes early.
Identifying Geographic Atrophy
Comprehensive eye examination
An eye care professional examines the retina for signs of AMD progression and retinal cell loss.
Optical Coherence Tomography (OCT)
OCT provides detailed images of retinal layers and helps clinicians assess:
- Retinal thinning
- Photoreceptor loss
- Changes associated with GA progression
Fundus Autofluorescence (FAF)
FAF imaging is particularly useful in Geographic Atrophy because it highlights changes in the retinal pigment epithelium and helps map areas of retinal damage.
Fundus photography
Retinal photographs allow clinicians to document areas of atrophy and monitor changes over time.
Visual function testing
Tests may assess:
- Visual acuity
- Contrast sensitivity
- Visual field changes
Home monitoring
Some people may use tools such as Amsler Grids or digital monitoring technologies to identify changes in vision between appointments.
Any new distortion, sudden vision changes, or rapid deterioration should be reported promptly as these may indicate Wet AMD.
Supporting independence
Emerging and approved treatments
New treatments target biological pathways involved in retinal degeneration, including inflammation-related pathways such as the complement system.
These therapies aim to:
- Slow the expansion of areas of retinal damage
- Preserve remaining retinal function
- Delay further vision loss
Treatment decisions depend on factors including:
- Disease stage
- Rate of progression
- Individual health considerations
Monitoring progression
Regular monitoring allows healthcare professionals to:
- Track changes in retinal structure
- Assess disease activity
- Identify progression
Vision rehabilitation
Because GA can affect central vision, rehabilitation services can help people maintain independence.
Support may include:
- Magnification devices
- Accessible technology
- Reading aids
- Lighting adaptations
- Mobility support
Lifestyle management
Healthy lifestyle choices may support overall eye health, including:
- Avoiding smoking
- Maintaining cardiovascular health
- Eating a balanced diet
- Staying physically active
Supporting independence, and participation
Living with Geographic Atrophy involves adapting to changes in central vision while maintaining independence and quality of life.
People living with GA may experience challenges with:
- Reading
- Recognising faces
- Driving
- Managing household tasks
- Using technology
Practical strategies may include:
- Increasing lighting
- Using accessibility features on devices
- Learning new ways to complete daily activities
- Accessing low vision rehabilitation
The emotional impact of progressive vision loss is also important. Support from family, healthcare professionals, and patient communities can help people adapt and remain connected.
Patient experiences are essential in helping researchers and healthcare systems understand the outcomes that matter most to people living with GA.
Advancing the future of Geographic Atrophy treatment
Complement pathway research
The complement system, part of the immune system, plays an important role in inflammation and retinal health.
Researchers are investigating therapies that modify complement activity to slow GA progression.
Learn About Complement pathway researchGene therapy
Researchers are exploring approaches that may:
- Protect retinal cells
- Replace damaged cells
- Address underlying disease mechanisms
Advanced imaging
Advanced imaging technologies help researchers:
- Detect GA earlier
- Measure disease progression
- Evaluate treatment effectiveness
Clinical trials
Clinical trials continue to investigate new medicines and treatment strategies aimed at preserving vision and improving quality of life.
Patient involvement remains essential to ensuring that research outcomes reflect the priorities and experiences of people living with GA.
Learn About Clinical trialsArtificial intelligence and imaging
AI technologies may support:
- Earlier detection
- Disease monitoring
- Prediction of progression
Information and community support
Take the Next Step
Geographic Atrophy represents an important area of progress in retinal research. While it can cause significant vision challenges, advances in diagnosis, monitoring, and emerging treatments are changing the future for people living with advanced Dry AMD.
Through collaboration between patients, researchers, clinicians, and communities worldwide, Retina International continues to support innovation and work towards better outcomes for everyone affected by retinal conditions.
