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. 2025 Oct 18;45(1):412.
doi: 10.1007/s10792-025-03781-2.

Patient-reported visual difficulties associated with geographic atrophy from age-related macular degeneration

Liangbo Linus Shen  1   2 , Carol A Applegate  3 , Gary S Rubin  4 , Janet S Sunness  5
Affiliations

Patient-reported visual difficulties associated with geographic atrophy from age-related macular degeneration

Liangbo Linus Shen et al. Int Ophthalmol. .

Abstract

Purpose: To characterize visual difficulties associated with geographic atrophy (GA).

Methods: A prospective study included 91 participants with bilateral GA. A visual activities questionnaire was administered at baseline and annually for 2 years along with best-corrected visual acuity (BCVA) and GA size. Baseline questionnaire responses were compared using logistic regressions, and longitudinal changes were analyzed with generalized linear mixed-effect models. A small group of 12 participants with drusen without GA served as a comparison to participants with GA and good VA.

Results: Compared to drusen participants, bilateral GA participants with BCVA of 20/50 or better reported significantly more difficulties in 8 vision-specific tasks. The frequencies of difficulty in reading small print, trouble with face recognition, and stopping driving were positively associated with GA severity cross-sectionally, measured by either BCVA or GA size, and increased over 2 years (P < 0.05 for each). Additional significant longitudinal changes included difficulty seeing in dim light (P = 0.005) and locating a sign (P = 0.008).

Conclusion: Reading, vision in dim illumination, face recognition, locating signs, and driving worsen over 2 years in patients with GA, and may be the appropriate self-reported items to monitor in a clinical trial. These findings highlight the need for therapies addressing both GA enlargement and visual function decline.

Keywords: Age-related macular degeneration; Best-corrected visual acuity; Geographic atrophy; Quality of life; Visual activities questionnaire; Visual function.

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Conflict of interest statement

Declarations. Conflict of interest: Authors CAA and GSR declare that they have no financial interests. LLS has received consultant honoraria from Boehringer Ingelheim and Sanofi. JSS serves as the chair of DSMB for OpRegen trial. Ethical approval: This is an observational study. The Wilmer Eye Institute Institutional Review Board has approved the study. Consent to participate: Informed consent was obtained from all individual participants included in the study.

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