In intermediate dry AMD, where can geographic atrophy exist but not affect directly?

In the context of intermediate dry age-related macular degeneration (AMD), geographic atrophy typically refers to the progressive degeneration of retinal pigment epithelium (RPE) and underlying photoreceptors. This process can exist in various areas of the retina, but its implications and direct impacts can differ depending on the location.

The foveal center is crucial for high-acuity vision due to its dense population of cones. If geographic atrophy were to affect this area, it could significantly impair visual acuity since the fovea is responsible for our sharpest vision. Thus, geographic atrophy is typically not directly affecting the foveal center in cases categorized as intermediate dry AMD, as this stage may allow for the presence of atrophy in other areas without immediately compromising central vision.

In contrast, geographic atrophy can occur in the periphery of the retina, around the optic nerve head, or in the broader posterior pole without impacting the center of the fovea directly. This distinction is critical for understanding how geographic atrophy progresses and its potential impact on visual function in patients with intermediate dry AMD.