While lesion growth in advanced dry AMD may appear to proceed slowly, disease progression is often constant and irreversible.15, 17
Progression can be highly variable, it typically takes several years from the onset of advanced dry AMD to cause consistent deficits in vision.26
This is because the fovea, which is responsible for
central vison and visual acuity, may be spared until
advanced dry AMD is very advanced.26
However even before the fovea is affected by advanced
dry AMD, lesion growth is already affecting functional vision.10, 15
of patients with wet
AMD progressed to
advanced dry AMD over
an average of 7.3 years
Advanced Dry AMD
Advanced dry AMD or Geographic
Atrophy is a term used to describe the
advanced form of dry age-related macular degeneration (AMD), is a progressive and
irreversible disease affecting the macula,
the central part of the retina.1, 2
Currently advanced dry AMD affects more than
5 million people worldwide. This number is expected to increase to more than 10 million by 2040.3
From age 50, prevalence quadruples every
Advanced dry AMD
accounts for up to 20% of all legal
to AMD.1, 5
Advanced dry AMD is a chronic progressive degeneration6 of the macula, which is a central part of the retina that allows the eye to see accurate details for daily activities.7, 8
The retina contains millions of light-sensitive cells
(rods and cones) that receive and organize visual information.7
The fovea at the center of the
macula is a small pit that contains the largest concentration of cone cells thus provides greatest visual acuity.9
Drusen are small yellow deposits of fatty proteins (lipids) that
accumulate under the retina. They can be used to grade the stage and severity of AMD.10
Advanced dry AMD and wet age-related
macular degeneration (wAMD) are different
manifestations of advanced AMD.11
An eye with advanced dry AMD can also
naturally develop wet AMD; and vice versa.11
In people with AMD, the photoreceptors in the macula, the part of the retina responsible for sharp vision and color recognition, deteriorate.14
Advanced dry AMD is characterized by progressive and irreversible
loss of the retinal pigment epithelium, photoreceptors, and underlying choriocapillaris, all of which are key components of the macula.2, 15
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.
The most predictive and central feature of developing advanced dry AMD is larger (>125 μm) or merging drusen as over 95% of patients with these features develop advanced dry AMD.15
Advanced dry AMD can be diagnosed and monitored by an ophthalmologist,
retinal specialist or optometrist.20
Retinal imaging techniques are used to identify, diagnose and monitor all stages of AMD, including advanced dry AMD. When diagnosing and monitoring AMD, your eye doctor will look for the following features in the retina by applying ophthalmoscopy or on fundus photo.21, 22 This may include:
Decorated with drusen.
A sharply demarcated area in the macular region with an atrophic retina, lacking pigmentation.
Visible underlying choroidal blood vessels.
Fundus autofluorescense angiography imaging is currently a standard imaging technology to visualize the retinal pigment epithelium (RPE) in advanced dry AMD.23
Optical coherence tomography (OCT): The atrophy of the retinal layers can be clearly seen with this non-invasive imaging technique.24, 25
While lesion growth in advanced dry AMD may appear to proceed slowly,
disease progression is constant and irreversible.15, 17–19
To date, there are no approved therapies to reduce the rate of advanced dry AMD
progression, although several potential therapies are under investigation.16
Modulating the visual cycle to reduce the accumulation of toxic byproducts
Reducing or inhibiting drusen formation
Complement inhibition to regulate an overactive complement system
Improving blood flow in the choroid
Reducing or eliminating oxidative stress
Reducing or eliminating inflammation
Replacing, repairing, or regenerating lost RPE cells and photoreceptors
Progression of advanced dry AMD may be managed through regular eye
examinations and early detection of the retinal changes.
In addition to regular eye examinations, the disease can also be managed through visual rehabilitation with the use of magnifiers and low vision aids.
Some simple approaches that can help prevent or slow the
progression advanced dry AMD include:
For more information visit dryAMD.eu
Advanced dry age-related macular
degeneration (AMD) / Geographic Atrophy (GA)
There is an increased chance of
being diagnosed with advanced dry AMD the older people become.
People with a family history are at a higher risk of developing the condition.
The prevalence of advanced dry AMD is highest among older people of Caucasian descent.
Smoking tobacco and cigarettes increases the likelihood of
developing advanced dry AMD.
Body Mass Index (BMI):
Individuals with a BMI of 30 and over are more susceptible to
developing advanced dry AMD.
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.
Usage of medications:
Certain medications have been linked with an increased risk
of developing AMD. If you are
taking any medication for other conditions you should discuss this with your healthcare professional.
A visual shows a cut through the eye, with the retina and macula at the back of the eye.
This section explains what dry age-related macular degeneration and geographic atrophy are and how they affect the back of the eye.
Medium-sized drusen or one large drusen.
million with advanced dry AMD3
AMD or Geographic Atrophy
or wet AMD
An overview of the three stages of AMD and the number of people affected.
Early Stage AMD13
Few small and medium-sized drusen.
Some loss of
peripheral low light vision. Patient
only notes under certain conditions or through designed tests.
Growth of non-
Loss of peripheral, low light vision.
Beginning to affect fovea, central vision
Loss of peripheral, low vision; patches of lost central
Loss of central vision leading to blindness.
© 2021 Apellis Switzerland GmbH. All rights reserved.
This infographic is intended for an audience outside the United States.
Visit www.dryAMD.eu for more information
Image: Fundus photograph of advanced dry AMD.
Image: Fundus photograph of a healthy eye.
How vision works
Advanced forms of AMD
This infographic about advanced dry AMD is not a diagnosis tool.
Please consult a healthcare professional if you believe you are suffering from AMD.
fundus autofluorescence of a retina
Image: Horizontal OCT scan over the fovea
Simplified image to illustrate healthy and deteriorated photoreceptors.
dry AMD in both eyes within 7 years of