Geographic Atrophy

The IFA’s commitment to improving awareness of eye health in the context of maintaining functional ability into older age focuses on educating older people and their families on the potential threats to their vision health, including Geographic Atrophy, as they age. The global population is ageing, and individual life spans are longer that they ever have been before. With an older demographic, there is a growing number of people living with eye diseases such as Geographic Atrophy.

There remains an urgent need to improve coordination between the public health capacity for addressing vision health and advocacy. Canadians in general are not well aware of the broad impact that vision loss has on the personal, social and health related to the quality of life of older people1. Given that the prevalence of age-related eye diseases is expected to double over the next thirty years, it is essential that opportunities for enhanced vision health be fully explored and implemented1.

This site is purposefully developed as a comprehensive resource centre for information on risk factors associated with developing Geographic Atrophy, early signs of the disease development, how to manage the disease and how it can be treated.

What is Geographic Atrophy?

  • Geographic Atrophy (GA) is a progressive form of age-related macular degeneration (AMD) disease known to be one of the main vision disabling diseases, mostly targeting older people1.
  • Age-related macular degeneration (AMD) affects the central part of the retina that allows the eye to see accurate details for daily activities such as driving, reading and recognizing faces. As such it has severe consequences on a person’s autonomy and independence 1.
  • Geographic Atrophy, also known a non-exudative or dry AMD, affects approximately 85% of patients who have been diagnosed with AMD 2.

What are the risk factors associated with Geographic Atrophy?

  • Age: There is an increased chance of being diagnosed with Geographic Atrophy the older people become, especially for those over 75 years of age.
  • Ethnicity: The prevalence of Geographic Atrophy is highest among older people of Caucasian descent 4.
  • Eye Colour: Ultra violet rays emitted from the sun can cause eye damage in older people with light-coloured eyes 2. Older people with light coloured eyes are more susceptible to ultra violet ray emissions because of low melanin content which protects the retina of the eyes from the direct sun rays 5.
  • Family History: People with a family history of geographic atrophy, either immediate or distant are at a higher risk of developing the condition2.
  • Environmental Factors, including:
    • Smoking tobacco and cigarettes increases the likelihood of developing Geographic Atrophy 3.
    • Body Mass Index (BMI): Individuals with a BMI of 30 and over are more susceptible to developing Geographic Atrophy 3.
    • Fatty diets: Consumption of foods high in cholesterol and fat can increase a person’s glycemic index which causes disposition of adipose tissue in the blood vessels of the retina contributing to the risk factors of progressive forms of AMD such as Geographic Atrophy4.
    • Usage of drugs: Diuretics, aspirin, antacids, hydrochlorothiazide, anti-inflammatories, thyroid hormones, beta-blockers, and hormone usage for older women can increase older people’s risk of developing Geographic Atrophy 1.

How is Geographic Atrophy detected? 2

  • Geographic Atrophy can be diagnosed only by a qualified health professional such as an ophthalmologist or a retinal specialist through clinical exams.

What are some early signs and symptoms of Geographic Atrophy? 1

  • Hazy or blurred vision.
  • Straight lines may appear crooked.
  • An inability to see details closely, as well as difficulty identifying objects from a distance.
  • A small, but growing, blind spot in the centre of vision.
  • Inability to identify and distinguish colours.

How can Geographic Atrophy be treated? 2, 3

  • Currently, there is no approved or effective treatment to prevent or impede the progression of Geographic Atrophy. Notwithstanding this, reducing disease progression through early detection benefits both patients and their caregivers as it may preserve visual function and as such, personal independence longer. It is important to have regular eye examinations in order to manage the progression of Geographic Atrophy.

How can Geographic Atrophy be managed?

  • Regular eye examinations: Progression of Geographic Atrophy can be managed through regular eye examinations and early detection of the retinal changes 2.
  • Visual rehabilitation: In addition to regular eye examinations, the disease can also be managed through visual rehabilitation with the use of magnifiers and low vision aids 2.
  • Improved quality of life: It is important for older people to adapt healthier lifestyles to reduce their risk of developing Geographic Atrophy 3. Some simple intervention strategies that can help prevent geographic atrophy include:
    • Cessation of smoking
    • Exercising to reduce BMI
    • Eating foods low in cholesterol
References:
  1. “Age-Related Macular Degeneration (AMD) Take a Closer Look… Before it’s too Late a Journalist’s Guide to AMD.” Canadian National Institute for the Blind. 2007. Accessed August 21, 2017.
  2. “Guidelines for the Collaborative Management of Persons with Age-Related Macular Degeneration by Health- and Eye-Care Professionals.” The Canadian Journal of Optometry. 77, no. 1. Accessed August 21, 2017.
  3. The Royal College of Ophthalmologists 2013. “Age-Related Macular Degeneration: Guidelines for Management.” The Royal College of Ophthalmologists. 2013. Accessed August 21, 2017.
  4. VanderBeek, Brian L. et al. “Racial Differences in Age-Related Macular Degeneration Rates in the United States: A Longitudinal Analysis of a Managed Care Network.” American journal of ophthalmology2 (2011): 273–282.e3. PMC. Accessed 21 Aug. 2017.
  5. Mitchell, Paul, Wayne Smith, and Jie Jin Wang. “Iris color, skin sun sensitivity, and age-related maculopathy: the Blue Mountains Eye Study.” Ophthalmology 105.8 (1998): 1359-1363.