This article is more than 5 years old. Information may no longer be current.

Surgeon: Consider geographic atrophy when managing AMD

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

WAIKOLOA, Hawaii — In determining the proper treatment of retinal disease, it can be just as important to understand the similarities between age-related macular degeneration and geographic atrophy as to understand the differences that distinguish them, said Michael L. Klein, MD.

“We always hear people talk about whether they are one or two diseases,” Dr. Klein said here at Retina 2005, held in conjunction with Hawaii 2005, The Royal Hawaiian Eye Meeting. “Geneticists are interested in dividing them into phenotypes and compartmentalizing them to make it easier to find the genes. But I think we have to agree that it is really probably one disease with the more general process of angiogenesis that comes in.”

Geographic atrophy (GA), characterized as end-stage atrophic AMD, has unique clinical features, including sharply demarcated, depigmented, visible choroidal vessels. Its growth can vary, but studies have shown that the borders of GA expand by an average of 139 µm per year, Dr. Klein said.

It is difficult to see GA because it is typically obscured by the presence of CNV, he said. The precursors of GA lesions typically appear after the resolution of CNV.

In many cases, GA can evolve from a patch of confluent, large drusen, he said. This is followed by hyperpigmentation, and then by fading of the drusen, disappearance of hyperpigmentation and the development of hypopigmentation.

Understanding this process could come into play as recent studies regarding treatment of drusen with laser emerge, Dr. Klein said.

“The laser-to-drusen studies are preoccupied with trying to prevent neovascularization. It may turn out that there is a role in preventing GA also,” he said. “If we can cause regression in drusen, we may be able to avoid GA. At least it’s a theoretical possibility.”