PDF(Pubmed)
Abstract：
Geographic atrophy (GA) is an advanced stage of age-related macular degeneration (AMD) that leads to gradual and permanent vision loss. GA is characterized by the loss of photoreceptor cells and retinal pigment epithelium (RPE), leading to distinct atrophic patches in the macula, which tends to increase with time. Patients with geographic atrophy often experience a gradual and painless loss of central vision, resulting in difficulty reading, recognizing faces, or performing activities that require detailed vision. The primary risk factor for the development of geographic atrophy is advanced age; however, other risk factors, such as family history, smoking, and certain genetic variations, are also associated with AMD. Diagnosis is usually based on a comprehensive eye examination, including imaging tests such as fundus photography, optical coherence tomography (OCT), and fluorescein angiography. Numerous clinical trials are underway, targeting identified molecular pathways associated with GA that are promising. Recent approvals of Syfovre and Izervay by the FDA for the treatment of GA provide hope to affected patients. Administration of these drugs resulted in slowing the rate of progression of the disease. Though these products provide treatment benefits to the patients, they do not offer a cure for geographic atrophy and are limited in efficacy. Considering these safety concerns and limited treatment benefits, there is still a significant need for therapeutics with improved efficacy, safety profiles, and better patient compliance. This comprehensive review discusses pathophysiology, currently approved products, their limitations, and potential future treatment strategies for GA.
摘要：
地理萎缩（GA）是年龄相关性黄斑变性（AMD）的晚期阶段，导致逐渐和永久性的视力丧失。GA的特征是感光细胞和视网膜色素上皮（RPE）的损失，导致黄斑中明显的萎缩性斑块，这往往会随着时间的推移而增加。患有地理萎缩的患者通常会逐渐无痛地丧失中央视力，导致阅读困难，识别面孔，或进行需要详细视野的活动。地理萎缩发展的主要危险因素是高龄；然而，其他风险因素，比如家族史,吸烟,和某些遗传变异，也与AMD有关。诊断通常基于全面的眼部检查，包括成像测试，如眼底摄影，光学相干断层扫描(OCT),和荧光血管造影.许多临床试验正在进行中，靶向确定了与GA相关的有前途的分子途径。FDA最近批准Syfovre和Izervay治疗GA为受影响的患者提供了希望。这些药物的施用导致疾病进展速度减慢。虽然这些产品为患者提供治疗益处，它们不能治疗地理萎缩，疗效有限。考虑到这些安全问题和有限的治疗益处，仍然非常需要具有改善功效的疗法，安全概况,和更好的患者依从性。这篇综合综述讨论了病理生理学，目前批准的产品，其局限性,以及未来可能的GA治疗策略。
