ABSTRACT
Geographic atrophy (GA) of the retinal pigment epi-
thelium (RPE) is the advanced form of non-
neovascular age-related macular degeneration
(AMD) and is associated with gradual, progressive
loss of central vision. Dense scotomas have been
shown to correspond to the retinal areas affected by
GA (1). These scotomas involve the parafoveal and
perifoveal retina early in the course of the disease,
sparing the foveal center until late in the course of the
disease (2-5). Consequently, GA is responsible for
approximately 20% of the legal blindness secondary
to AMD, compared to choroidal neovascularization
(CNV), which tends to involve the foveal center much
earlier in the course of the disease and accounts for
nearly 80% of the legal blindness secondary to AMD
(6). However, the parafoveal and perifoveal scotomas
in the early stages of GA compromise the patient’s
ability to read and to recognize faces, often despite the
retention of good visual acuity, and account for a much
larger percentage of moderate visual loss in those
affected (7). In addition, GA is present binocularly in
most patients. The prevalence of GA in the population
75 years of age or older is approximately 3.5%, half
that of neovascular AMD (8,9), and increases to 22% in
those 90 years of age or older (10). While there are
treatments for CNV, there is presently no definitive
treatment available for GA. As our understanding of
GA grows, it is hoped that medical and surgical
interventions will be developed to completely halt its
progression rate and to prevent subsequent moderate
and severe visual loss.
