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Central 2.50-mm geographic atrophy extent correlates with visual function measures in age-related macular degenerationCentral vision loss impacts daily life for geographic atrophy patients

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Key Takeaway
Note that only the central 2.50-mm geographic atrophy region independently correlates with patient-reported vision scores.

This observational analysis of Phase III clinical trial data (Chroma and Spectri) included 856 individuals aged 50 years or more with bilateral geographic atrophy (GA) secondary to age-related macular degeneration (AMD). The study analyzed the relationship between topographic lesion distribution and patient-reported visual function.

Primary outcomes focused on the association between NEI VFQ-VF person measures and minimum eye-level GA extent. All measured diameters showed significant associations with these measures, including a positive association of R = 0.11 for the central 2.50-mm diameter region (P ≤ 0.001).

Multivariable analysis revealed that only the minimum GA extent within the central 2.50-mm region was independently associated with NEI VFQ-VF measures (P < 0.001). The 2.50- to 6.00-mm annulus did not show an independent association (P = 0.541).

Safety and tolerability data were not reported as the study analyzed secondary trial data rather than evaluating lampalizumab directly. Results suggest that central GA extent is a more specific indicator of self-reported visual functioning than broader lesion areas.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in understanding how structural changes specifically correlate with patient-reported outcomes in geographic atrophy. While previous coverage noted that CFH Y402H and ARMS2 A69S polymorphisms are associated with increased risk of age-related macular degeneration, and factors like smoking and age also increase risk, this study focuses on the specific anatomical regions within GA that most closely correlate with visual quality of life.

Living with geographic atrophy, a form of age-related macular degeneration, can make everyday tasks difficult. Researchers looked at data from 856 patients to understand which specific areas of vision loss affect a person's quality of life the most. They focused on how much damage occurred in different zones of the eye.

The study found that while several areas of vision loss were linked to lower quality of life scores, only one area stood out as a primary driver. Specifically, damage within the central 2.50-millimeter region was the main factor tied to how patients reported their visual functioning. Other larger areas showed less consistent results in these reports.

This finding helps doctors better understand what matters most for patient experience. It suggests that even small amounts of damage in the very center of the eye can have a big impact on a person's daily life. This research used data from existing clinical trials and did not test the safety or effectiveness of any specific medication.

What this means for you:
Damage in the central 2.50-mm area of the eye most impacts how patients with geographic atrophy experience their vision.

Common questions

What specific part of the eye matters most for quality of life?

The study found that only the minimum extent of geographic atrophy within the central 2.50-mm region was independently associated with how patients reported their visual functioning. While other areas showed some links, this central zone is the primary area tied to self-reported daily experience.

Who was included in this study?

The analysis included 856 individuals aged 50 years or older who had bilateral geographic atrophy. This condition is a specific type of age-related macular degeneration that affects both eyes.

Does this study prove a new treatment works?

No, this study did not evaluate the safety or effectiveness of any medication. It analyzed secondary data from clinical trials to see how structural changes in the eye relate to a patient's reported quality of life.

Study Details

Study typeRct
Sample sizen = 856
EvidenceLevel 2
Follow-up600.0 mo
PublishedAug 2026
View Original Abstract ↓
PURPOSE: To understand the associations between the topographic lesion distribution and vision-related quality of life (VR-QoL) in individuals with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). DESIGN: Analysis of data from Chroma (NCT02247479) and Spectri (NCT02247531), which are identically designed Phase III clinical trials of lampalizumab. PARTICIPANTS: A total of 856 participants who were aged 50 years or more with bilateral GA who completed the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) at baseline. METHODS: The NEI VFQ-25 was used to determine estimates of VR-QoL in the visual functioning (NEI VFQ-VF) domain, using calibrated item measures and rating category thresholds from the Rasch analysis. Geographic atrophy was automatically segmented on combined fundus autofluorescence and near-infrared reflectance images, and its extent in central regions across varying diameters (from 0.25 to 6.00 mm, in 0.25-mm intervals) relative to the fovea were then derived. MAIN OUTCOME MEASURES: Association between NEI VFQ-VF person measures and the minimum eye-level GA extent in the region evaluated within an individual (referred to as the "minimum GA extent"). RESULTS: Minimum GA extent within the central region across varying diameters between 0.25 and 6.00 mm were all significantly associated with the NEI VFQ-VF person measures (P ≤ 0.001 for all), but the highest proportion of variance explained was seen when evaluating the central 2.50-mm diameter region (R = 0.11). A multivariable analysis showed that only the minimum GA extent within the central 2.50-mm region (P < 0.001), but not the 2.50- to 6.00-mm annulus (P = 0.541), was independently associated with NEI VFQ-VF person measures. CONCLUSIONS: In this cohort, VR-QoL is most strongly associated with minimum eye-level GA extent within the central 2.50-mm region within an individual. These findings underscore the importance of evaluating GA extent in this region, beyond simply considering foveal GA involvement, when seeking to evaluate structural changes most closely associated with self-reported impairments in visual functioning. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
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