How Geographic Atrophy Is Treated

Maxine Lipner
·5 min read

Medically reviewed by Christine L. Larsen, MD

Geographic atrophy treatment options remain limited. Treatment pathways for this advanced eye condition range from making lifestyle changes to prevent it from occurring to methods of maximizing remaining vision.

This article will discuss treatment for geographic atrophy, including lifestyle changes, over-the-counter vitamins, vision-maximizing procedures, and other possibilities.

<p>Suphaporn / Getty Images</p>

Suphaporn / Getty Images

Home Remedies and Lifestyle

Your lifestyle can play a role in helping to keep geographic atrophy at bay, including:

  • Smoking is the most modifiable risk factor. Harmful chemicals from smoking can travel through the bloodstream and damage the retina. The smoke can irritate the retinal cells, charging up the immune system and causing problematic inflammation. It's advisable to quit smoking if you smoke.

  • Having obesity can heighten your risk of geographic atrophy. Losing excess weight may be helpful.

  • Bringing high cholesterol levels under control with diet or medication may help.

  • Consider reducing high blood pressure with diet or medication.

  • Too much sun exposure can damage the eyes. Wearing sunglasses and wide-brimmed hats while outside can help keep the sun out of your eyes.

Over-the-Counter Therapies

For geographic atrophy, some look to vitamins in order to potentially slow progression. You can find these on the shelf at your local pharmacy. Possibilities include:

  • Lutein (either with or without zeaxanthin) may be taken. These are powerful antioxidants that have been shown to slow the progression of geographic atrophy only slightly.

  • AREDS2 formula, which contains lutein, zeaxanthin, vitamin E, zinc oxide, and cupric oxide, has been shown to slow the progression of dry age-related macular degeneration (AMD) to advanced AMD by 25%. It is in this late stage that central vision loss occurs, so halting progression may be beneficial.

  • AREDS1 formula contains beta carotene in addition to lutein and zeaxanthin. One drawback is that beta carotene has been linked to lung cancer in people who smoke or previously smoked.

Prescriptions

In 2023, the Food and Drug Administration (FDA) approved Izervay (avacincaptad pegol) and Syfovre (pegcetacoplan) to treat adults who have geographic atrophy caused by AMD.

Izervay and Syfovre are the first-ever FDA-approved treatments for geographic atrophy and come as a solution that is injected directly into the eye and slows the progression of geographic atrophy.

Surgeries and Specialist-Driven Procedures

One of the options for treating geographic atrophy is to maximize the vision that you still have. A way to do this is to get a referral to a low-vision specialist who can recommend different technology that can help. Here are some possibilities:

  • Magnifying glass: This simple, often handheld device can make print size larger and easier for functional parts of your retina to identify.

  • Large-print reading materials: Large print can be easier to decipher by the intact parts of your retina.

  • Telescopic lenses: These can assist you in viewing things at a distance, such as a house number, a billboard, or a TV.

  • Lighting controls: The brighter the light, the easier it can be to see certain images.

  • Video magnifying technology: With this, a camera magnifies an image, and then the image is projected onto a video screen, enabling those with geographic atrophy to view the image more clearly.

Implantable Miniature Telescope

Some people with geographic atrophy may benefit from an implantable miniature telescope. Normally, the lens of the eye focuses light rays on the light-sensitive retina at the back of the eye. Macular degeneration and geographic atrophy affect the retina.

This device replaces the natural lens and is helpful for late-stage age-related macular degeneration in people whose vision is compromised in both eyes.

Much like a magnifying glass, the implantable miniature telescope can make use of the parts of your retina that continue to work, which usually are in your peripheral (side) vision. This technology can help with visual tasks ranging from reading to recognizing faces.

To see if you would be a good candidate for this approach, you will be offered the trial use of an external telescope. Your ophthalmologist will then test you to detect whether there is any improvement in your vision. A provider will want to ensure that your vision improves enough to read at least five lines on a vision chart.

Complementary and Alternative Medicine (CAM)

In cases in which Western medicine comes up short in treating geographic atrophy, some people seek an alternative or complementary approach.

Acupuncture is rooted in ancient Chinese medicine. The technique involves putting very slender needles in the skin at specific points to achieve a therapeutic goal. Exactly how this works remains unclear, but the approach has been found to reduce pain and speed wound healing.

In a pilot study conducted at the University of Pittsburgh, investigators used acupuncture on people with dry AMD with varied success. They initially tested people to see their visual acuity and contrast sensitivity (ability to distinguish between light and dark) and gave a quality-of-life survey.

While some saw a significant improvement, improvement was minimal for others, and some participants gained no improvement. However, acupuncture did not worsen anyone's condition. But more study is needed here.

Summary

Syfovre (pegcetacoplan) and Izervay are the only treatments for geographic atrophy approved by the FDA. In addition, lifestyle can have a significant impact. Things like quitting smoking, losing excess weight, and reducing sun exposure may help circumvent the progression.

Vitamin supplements, such as the AREDS1 and AREDS 2 formulations, can also play a role. A variety of low-vision aids, from magnifying technology to a magnifying device implanted in the eye, can all help to maximize vision.

A Word From Verywell

While treatment options for geographic atrophy remain limited, there are ways to postpone this condition and various methods to optimize your vision. New treatments to either slow the progression or even cure it are under investigation.

Read the original article on Verywell Health.