Which part of the retina does Geographic Atrophy often spare until late in the disease course?

Geographic Atrophy (GA), a form of advanced dry age-related macular degeneration (AMD), typically presents a pattern of progressive thinning of the retinal pigment epithelium and underlying photoreceptors. One of the defining characteristics of GA is that it often spares the fovea until the later stages of the disease.

The fovea is the central part of the macula that is responsible for sharp central vision, which is crucial for tasks such as reading and recognizing faces. In the early and even intermediate stages of GA, individuals can maintain good visual acuity largely because the fovea remains intact. As the disease progresses, atrophy can eventually extend to involve the foveal area, leading to significant loss of central vision.

In contrast, the peripheral retina is often affected earlier in the course of diseases characterized by geographic atrophy, as it tends to show signs of damage or degeneration before the foveal region does. The optic nerve head and other non-macular regions are not typically involved in the specific degeneration pattern of GA. Therefore, understanding the typical progression of GA highlights how the fovea remains spared during the initial stages, making it crucial for both comprehension and patient care.