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GA can unravel your patients’ lives1-3

Consider your role in identifying GA

Vision loss

Vision loss from GA can occur before lesions reach the fovea4,5

Early detection and referral of GA is critical6,7

Foveal encroachment can happen as quickly as 2.5 years8*

Every millimeter matters9,10

Lesion foveal encroachment can result in irreversible photoreceptor loss

Consider the impact of irreversible GA lesion growth1

*In a study of GA patients, of those who developed central GA, the median time to development was just 2.5 years (from a subpopulation of a retrospective analysis (n=397) within the larger AREDS prospective study (N=3640)). These data were based on a retrospective subset analysis from The Age-related Eye Disease Study (AREDS) #26, a long-term, multicenter, prospective study examining progression of GA area in a cohort of 3640 patients with signs of early and more advanced forms of AMD.8

Identifying AMD and GA on OCT scans

Click on the tabs below to learn more.

  • Medium-sized drusen >63 µm and ≤125 µm
  • No pigmentary abnormalities

Few medium-sized drusen

Early AMD

©2018. This work is licensed under a CC BY 4.0 license. "Advanced imaging for the diagnosis of age-related macular degeneration: a case vignettes study", "Figure 2 Case 1", Ly A, Nivision-Smith L, Zangerl B, Assad N, Kalloniatis M. Clin Exp Optom.

  • Large drusen >125 µm and/or pigmentary abnormalities
  • Can lead to GA, nAMD, or both GA and nAMD

Drusen grow larger with disease progression

Hyperreflective foci representing RPE migration

Intermediate AMD

©2023. This work is licensed under a CC BY 4.0 license. “Correlation between hyperreflective foci and visual function testing in eyes with intermediate age-related macular degeneration”, "Figure 1", Liu TYA, Wang J, Csaky KG. Int J Retina Vitreous.

GA

  • Atrophy of photoreceptors and the loss of RPE can lead to increased reflectivity below Bruch’s membrane and resulting hypertransmission14,15
  • Even if visual acuity or BCVA is relatively unchanged, functional vision continues to decline as lesions progress1,5,16
  • Patients with GA can also naturally develop nAMD and vice versa. Up to 29% of patients with GA develop nAMD in about 2 years (N=12,309)17†

Hypertransmission seen in GA

Loss of RPE and photoreceptors

Advanced AMD

Neovascular AMD (nAMD)

  • Distinguished by abnormal blood vessels that may cause fluid or blood to leak into the macula15
  • Up to 37% of patients with nAMD develop GA in about 2 years (n=35)18‡

Fluid leakage extending from the choroidal vessels through Bruch’s membrane

Choroidal neovascular membrane

Advanced nAMD

Image courtesy of Mohammad Rafieetary, OD, Charles Retina Institute.

†Retrospective analysis (N=12,309) of the Intelligent Research in Sight (IRIS) Registry database in patients with GA in the study eye and nAMD in the fellow eye (n=3607/12,309).17

Images courtesy of Dr Juan David Arias and Dr Andrea Hoyos, Colombia.

SYFOVRE is only indicated for the treatment of GA secondary to AMD.

‡Retrospective cohort analysis (N=94 eyes) to assess growth of GA in patients with nAMD treated with anti-VEGF therapy.18

GA
nAMD

Patients with GA may experience one or more of these symptoms4,19

Straight lines that appear crooked
Hazy or blurred vision
Blurry spots in the center of vision
Dull or washed-out colors
Difficulty seeing in low light
Missing spots in vision

Know the key risk factors for the development of GA

Key GA risk factors include:

Genetics20
  • Family history (genetic predisposition)
Physiology20
  • Obesity
  • Certain dyslipidemias
  • Cardiovascular disease/hypertension
Lifestyle/Environment20
  • History of smoking
  • Diet
Clinical findings from imaging
  • GA in fellow eye14
  • Increased drusen volume22
Age: From age 50 and onwards, the prevalence of GA quadruples every 10 years21

Identify and refer early—GA can progress faster than you think

AMD=age-related macular degeneration; BCVA=best-corrected visual acuity; GA=geographic atrophy; nAMD=neovascular age-related macular degeneration; OCT=optical coherence tomography; RPE=retinal pigment epithelium; VEGF=vascular endothelial growth factor.

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Understanding Complement

References:  1. Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, Henry EC, Brittain C. The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target. Retina. 2017;37(5):819-835. doi:10.1097/iae.0000000000001392. 2. Pfau M, von der Emde L, de Sisternes L, et al. Progression of photoreceptor degeneration in geographic atrophy secondary to age-related macular degeneration. JAMA Ophthalmol. 2020;138(10):1026-1034. 3. Bird AC, Phillips RL, Hageman GS. Geographic atrophy: a histopathological assessment. JAMA Ophthalmol. 2014;132(3):338-345. 4. Sacconi R, Corbelli E, Querques L, Bandello F, Querques G. A review of current and future management of geographic atrophy. Ophthalmol Ther. 2017;6(1):69-77. doi:10.1007/s40123-017-0086-6. 5. Sunness JS, Margalit E, Srikumaran D, et al. The long-term natural history of geographic atrophy from age-related macular degeneration: enlargement of atrophy and implications for interventional clinical trials. Ophthalmology. 2007;114(2):271-277. doi:10.1016/j.ophtha.2006.09.016. 6. Neely DC, Bray KJ, Huisingh CE, et al. Prevalence of undiagnosed age-related macular degeneration in primary eye care. JAMA Ophthalmol. 2017;135(6):570-575. doi:10.1001/jamaophthalmol.2017.0830. 7. Kaiser PK, Karpecki PM, Regillo CD, et al. Geographic Atrophy Management Consensus (GA-MAC): a Delphi panel study on identification, diagnosis and treatment. BMJ Open Ophthalmol. 2023 Oct;8(1):e001395. doi: 10.1136/bmjophth-2023-001395. 8. Lindblad AS, Lloyd PC, Clemons TE, et al; Age-Related Eye Disease Study Research Group. Change in area of geographic atrophy in the age-related eye disease study: AREDS report number 26. Arch Ophthalmol. 2009;127(9):1168-1174. doi:10.1001/archophthalmol.2009.198. 9. Wells-Gray EM, Choi SS, Bries A, Doble N. Variation in rod and cone density from the fovea to the mid-periphery in healthy human retinas using adaptive optics scanning laser ophthalmoscopy. Eye (Lond). 2016;30(8):1135-1143. 10. van Lookeren Campagne M, LeCouter J, Yaspan BL, Ye W. Mechanisms of age-related macular degeneration and therapeutic opportunities. J Pathol. 2014;232(2):151-164. doi:10.1002/path.4266. 11. Ferris FL 3rd, Wilkinson CP, Bird A, et al. Beckman Initiative for Macular Research Classification Committee. Clinical classification of age-related macular degeneration. Ophthalmology. 2013;120(4):844-51. doi:10.1016/j.ophtha.2012.10.036. 12. Ruan Y, Jiang S, Gericke A. Age-related macular degeneration: role of oxidative stress and blood vessels. Int J Mol Sci. 2021;22(3):1296. doi:10.3390/ijms22031296. 13. Jager RD, Mieler WF, Miller JW. Age-related macular degeneration. N Engl J Med. 2008; 358(24):2606-2617. doi:10.1056/NEJMra0801537. 14. Fleckenstein M, Mitchell P, Freund KB, et al. The progression of geographic atrophy secondary to age-related macular degeneration. Ophthalmology. 2018;125(3):369-390. doi:10.1016/j.ophtha.08.038. 15. Chakravarthy U, Bailey CC, Scanlon PH, et al. Progression from early/intermediate to advanced forms of age-related macular degeneration in a large UK cohort: rates and risk factors. Ophthalmol Retina. 2020;4(7):662-672. doi:10.1016/j.oret.2020.01.012. 16. Kimel M, Leidy NK, Tschosik E, et al. Functional reading independence (FRI) index: a new patient-reported outcome measure for patients with geographic atrophy. Invest Ophthalmol Vis Sci. 2016;57(14):6298-6304. doi:10.1167/iovs.16-20361. 17. Rahimy E. Evaluating geographic atrophy in real-world clinical practice: new findings from the IRIS registry. Presented at: American Academy of Ophthalmology Meeting; November 14, 2020; virtual meeting. 18. Xu L, Mrejen S, Jung JJ, et al. Geographic atrophy in patients receiving anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Retina. 2015;35(2):176-186. doi:10.1097/IAE.0000000000000374. 19. Schultz NM, Bhardwaj S, Barclay C, Gaspar L, Schwartz J. Global burden of dry age-related macular degeneration: a targeted literature review. Clin Ther. 2021;43(10):1792-1818. doi:10.1016/j.clinthera.2021.08.011. 20. Sobrin L, Seddon JM. Nature and nurture- genes and environment- predict onset and progression of macular degeneration. Prog Retin Eye Res. 2014;40:1-15. doi:10.1016/j.preteyeres.2013.12.004. 21. Rudnicka AR, Jarrar Z, Wormald R, Cook DG, Fletcher A, Owen CG. Age and gender variations in age-related macular degeneration prevalence in populations of European ancestry: a meta-analysis. Ophthalmology. 2012;119:571-580. doi:10.1016/j.ophtha.2011.09.027. 22. Lad EM, Finger RP, Guymer R. Biomarkers for the progression of intermediate age-related macular degeneration. Ophthalmol Ther. 2023;12:2917-2941. doi: 10.1007/s40123-023-00807-9.

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IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • SYFOVRE is contraindicated in patients with ocular or periocular infections, and in patients with active intraocular inflammation

WARNINGS AND PRECAUTIONS

  • Endophthalmitis and Retinal Detachments
    • Intravitreal injections, including those with SYFOVRE, may be associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering SYFOVRE to minimize the risk of endophthalmitis. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately.
  • Retinal Vasculitis and/or Retinal Vascular Occlusion
    • Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported with the use of SYFOVRE. Cases may occur with the first dose of SYFOVRE and may result in severe vision loss. Discontinue treatment with SYFOVRE in patients who develop these events. Patients should be instructed to report any change in vision without delay.
  • Neovascular AMD
    • In clinical trials, use of SYFOVRE was associated with increased rates of neovascular (wet) AMD or choroidal neovascularization (12% when administered monthly, 7% when administered every other month and 3% in the control group) by Month 24. Patients receiving SYFOVRE should be monitored for signs of neovascular AMD. In case anti-Vascular Endothelial Growth Factor (anti-VEGF) is required, it should be given separately from SYFOVRE administration.
  • Intraocular Inflammation
    • In clinical trials, use of SYFOVRE was associated with episodes of intraocular inflammation including: vitritis, vitreal cells, iridocyclitis, uveitis, anterior chamber cells, iritis, and anterior chamber flare. After inflammation resolves, patients may resume treatment with SYFOVRE.
  • Increased Intraocular Pressure
    • Acute increase in IOP may occur within minutes of any intravitreal injection, including with SYFOVRE. Perfusion of the optic nerve head should be monitored following the injection and managed as needed.

ADVERSE REACTIONS

  • Most common adverse reactions (incidence ≥5%) are ocular discomfort, neovascular age-related macular degeneration, vitreous floaters, conjunctival hemorrhage.

INDICATION

SYFOVRE® (pegcetacoplan injection) is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

Please see full Prescribing Information for more information.

INDICATION

SYFOVRE® (pegcetacoplan injection) is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • SYFOVRE is contraindicated in patients with ocular or periocular infections, and in patients with active intraocular inflammation

WARNINGS AND PRECAUTIONS

  • Endophthalmitis and Retinal Detachments
    • Intravitreal injections, including those with SYFOVRE, may be associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering SYFOVRE to minimize the risk of endophthalmitis. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately.
  • Retinal Vasculitis and/or Retinal Vascular Occlusion
    • Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported with the use of SYFOVRE. Cases may occur with the first dose of SYFOVRE and may result in severe vision loss. Discontinue treatment with SYFOVRE in patients who develop these events. Patients should be instructed to report any change in vision without delay.
  • Neovascular AMD
    • In clinical trials, use of SYFOVRE was associated with increased rates of neovascular (wet) AMD or choroidal neovascularization (12% when administered monthly, 7% when administered every other month and 3% in the control group) by Month 24. Patients receiving SYFOVRE should be monitored for signs of neovascular AMD. In case anti-Vascular Endothelial Growth Factor (anti-VEGF) is required, it should be given separately from SYFOVRE administration.
  • Intraocular Inflammation
    • In clinical trials, use of SYFOVRE was associated with episodes of intraocular inflammation including: vitritis, vitreal cells, iridocyclitis, uveitis, anterior chamber cells, iritis, and anterior chamber flare. After inflammation resolves, patients may resume treatment with SYFOVRE.
  • Increased Intraocular Pressure
    • Acute increase in IOP may occur within minutes of any intravitreal injection, including with SYFOVRE. Perfusion of the optic nerve head should be monitored following the injection and managed as needed.

ADVERSE REACTIONS

  • Most common adverse reactions (incidence ≥5%) are ocular discomfort, neovascular age-related macular degeneration, vitreous floaters, conjunctival hemorrhage.

INDICATION

SYFOVRE® (pegcetacoplan injection) is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

Please see full Prescribing Information for more information.

INDICATION

SYFOVRE® (pegcetacoplan injection) is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).