Treatment to slow or stop geographic atrophy (GA) had been unavailable, but pegcetacoplan, a newly approved injectable medication, has changed that.
Geographic atrophy (GA) is the late stage of dry age-related macular degeneration (AMD). AMD is an eye disease caused by damage to the macula — the part of your retina you use to see straight ahead. Until recently, there was no treatment specifically for GA, but that has changed.
About 1 million people in the United States have GA. Atrophy means that cells of the retina waste away and die. The loss of these cells can lead to permanent vision loss or even blindness.
If you have AMD or you’re at risk for it, your eye doctor will regularly check your retina for damage. You can also check for vision loss at home using an amsler grid.
In 2023, the first drug was approved to slow vision loss in GA.
Other treatments and visual rehabilitation programs can help you make the most of the vision you have.
In 2023, the Food & Drug Administration (FDA) approved the first drug to treat GA. Pegcetacoplan injection (Syfovre) targets an immune system protein that contributes to GA progression.
Syfovre is an injection you get from a retina specialist once a month or every 2 months. It’s approved for anyone with GA caused by AMD. Although Syfovore doesn’t cure GA, it can slow retinal atrophy by up to 36% with monthly injections.
This medicine has caused side effects in a small number of people. Side effects included:
- eye infections
- eye pain
- increased pressure in the eye
- bleeding in the eye
- neovascular AMD, an advanced form of AMD
- retinal detachment
Your eye doctor can tell you what to expect when you take this medicine, and when to call the office if you do have side effects.
The cost of Syfovre can vary depending on your insurance. Some insurance companies, as well as Medicare and Medicaid, will cover the cost.
If your health insurance won’t pay for Syfovre, the manufacturer offers a financial assistance program called ApellisAssist that might help cover the cost.
Visual rehabilitation is a program that helps you function better with low vision. You’ll meet with a low-vision specialist, who will teach you strategies to make your daily activities easier and help you stay independent.
Your low-vision specialist might recommend aids like:
- better lighting
- large-print books, newspapers, and magazines
- magnifying devices to enlarge print
- prescription glasses
- software to magnify the image on your computer screen
- telescopic lenses for distance viewing
- TVs that enlarge a printed page on the screen
The Age-Related Retinal Eye Diseases (AREDS) study shows that a supplement can slow the progression of intermediate- or late-stage AMD.
The AREDS2 supplement contains a combination of these vitamins and minerals:
- vitamin C
- vitamin E
- zinc oxide
The AREDS2 supplement can
AMD and GA damage the macula, the part of your retina that’s responsible for central vision. Damage in this part of your retina can affect your ability to see people’s faces, books, and the TV clearly.
The implantable miniature telescope (IMT) is a device that’s about the size of a pea. It magnifies objects in the center of your visual field by two to three times to help you see them more clearly.
Placing an IMT requires surgery. The doctor first removes your natural lens and then implants the IMT in its place.
IMT is FDA-approved for people with a corrected vision of 20/160-20/800 that is caused by end-stage AMD in both eyes.
A few new drugs are in late-stage clinical trials. These medicines aim to slow GA progression in different ways.
Some of the investigational drugs reduce oxidative stress — an imbalance of harmful molecules that can damage the retina. Others work on the complement system — immune system proteins involved in the development and progression of AMD.
A few drugs have not been successful in clinical trials. But an implant called the brimonidine drug delivery system (Brimo DDS) did seem to slow GA.
Other promising ways to slow GA include medicines to protect retinal cells from damage, and stem cell therapies.
GA is a progressive disease, which means that vision loss gets worse over time. Today, there is one approved drug that can slow the progress of GA. Researchers are investigating many other promising GA drugs in clinical trials. Your eye doctor can tell you whether you might be a good candidate for one of these studies.
Everyone’s outlook with GA is different. Your doctor will let you know what to expect, and what you can do to have a better quality of life if your vision loss does progress.
Pegcetacoplan is the first FDA-approved drug to treat GA. It can help slow the progression of the condition. You might also try visual rehabilitation. If you want to try one of the new GA drugs in development, ask your doctor about enrolling in a clinical trial.