Symmetry of Bilateral Lesions in Geographic Atrophy in Patients With Age-Related Macular Degeneration

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Abstract
AGE-RELATED macular degeneration (ARMD) is the most common cause for legal blindness in Western countries.1-6 Severe visual loss results from choroidal neovascularization (CNV), pigment epithelial detachment, or geographic atrophy (GA) of the retinal pigment epithelium(RPE).2-4,7-11 Geographic atrophy is less common than the neovascular form of ARMD. In about 12% to 21% of patients with advanced ARMD, severe loss of visual acuity results from foveal involvement of GA.2-4,10-16 The severity of visual loss from GA may be just as great as from CNV, but the process is much slower than with CNV. In contrast to CNV, GA tends to spare the fovea until late in the course of the disease. While GA usually develops in eyes with drusen and pigmentary alterations, it may also follow flattening of RPE detachments.17-20 Histopathologic examinations have shown that the atrophy is not confined to the RPE layer but also involves the corresponding choriocapillaris and outer neurosensory retina.21-23