Geographic Atrophy Future Treatment.

Geographic Atrophy Future Treatment.

A New Hope for Treating Geographic Atrophy in Age-Related Macular Degeneration

By Neil M. Bressler, MD, as told to Keri Wiginton

Age-related macular degeneration (AMD) is a common vision problem among individuals above the age of 65. While there are effective treatments available for the wet form of AMD, until recently, there were no therapeutics that directly targeted the root cause of geographic atrophy (GA), an advanced form of dry AMD. However, with the recent approval of the pegcetacoplan (Syfovre) injection by the FDA, there is new hope on the horizon. This breakthrough drug, administered through an eye injection on a monthly or bimonthly basis, is the first FDA-approved medication that can slow the progression of GA. The imminent approval of a similar drug called avacincaptad pegol (Zimura) further reinforces the positive developments in the treatment of GA.

While the pegcetacoplan injection is a step in the right direction, it’s crucial to recognize its limitations. While it can slow the growth of GA lesions, it cannot stop atrophy or reverse vision loss. In terms of safety, the injection is generally considered safe; however, it does come with certain risks. Clinical trials have shown that the incidence of wet AMD was only 3% among those who did not receive the medication. However, those who received the shot monthly or bimonthly had slightly higher rates of 12% and 7%, respectively.

Despite the limitations of the current treatment, the future of GA therapy looks promising. Ongoing research is focused on complement inhibitors, which target the overactive complement system believed to play a significant role in the development and progression of dry AMD. While pegcetacoplan is an anti-complement drug that targets the C3 pathway, avacincaptad pegol acts as a C5 inhibitor. Future therapies are likely to build upon these mechanisms, potentially addressing cell loss more effectively and leading to better vision outcomes.

In addition to complement inhibitors, modified forms of vitamin A, such as the oral drug ALK-001, show potential in slowing the growth of GA lesions and protecting the light-sensitive cells in the retina. While further research is needed to understand the full extent of ALK-001’s effectiveness, its exploration offers another avenue for treating GA.

Artificial intelligence (AI) is another area of interest in the quest to combat GA. Researchers are employing AI algorithms to analyze retina images and identify early signs of GA before significant cell loss occurs. By identifying biomarkers and predicting those at higher risk of developing GA, this approach opens the possibility of utilizing existing medications at earlier stages, potentially preventing further vision loss.

Looking further into the future, cell replacement therapy holds promise for individuals with GA. Designed to repair or replace damaged retinal tissue, scientists are investigating techniques to create healthy retinal cells from a person’s own tissue. By surgically replacing areas affected by atrophy with functional retinal cells, this therapy could offer a groundbreaking solution. However, extensive research is necessary to ensure safety, efficacy, and scalability for broader use.

Similarly, retinal implants show potential for restoring vision in GA patients. By connecting electronic receptors to the back part of the eye, these implants aim to transmit visual signals from the retina to the brain. While this technology is not yet available, ongoing advancements and breakthroughs offer hope for the future.

If you have GA, maintaining regular communication with your doctor is vital. Never lose hope, as new treatments and breakthroughs can emerge at any time. As we have witnessed already, advancements are continuously being made, offering new opportunities to combat GA and restore vision to those affected by this condition.