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Research Letter |

Spontaneous Improvement in Visual Acuity in Age-Related Geographic Atrophy of the Macula

Janet S. Sunness, MD1
[+] Author Affiliations
1Richard E. Hoover Low Vision Rehabilitation Services, Greater Baltimore Medical Center, Baltimore, Maryland
JAMA Ophthalmol. 2014;132(3):356-357. doi:10.1001/jamaophthalmol.2014.21.
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Geographic atrophy (GA) from age-related macular degeneration (AMD) is generally regarded as a monotonically worsening disorder. Unlike exudative AMD, in which improvements in visual acuity (VA) can occur as fluid resolves and neovascularization involutes, photoreceptor loss causing VA worsening in GA is irreversible. Successful therapy that stops the progression of disease will not restore function to a blind area. However, spontaneous improvement in VA can occur over time in eyes with GA. Microperimetry has shown that improvement is associated with better use of the eccentric retina in eyes that could not place the object of interest on the seeing retina at baseline.1 In a study of patients with bilateral GA followed up for 3 years, 17% improved by 2 or more lines in the worse-seeing eye on this basis, while no better-seeing eyes of the patients improved. The same phenomenon has been observed in the first-affected eye of patients with bilateral disciform scars.2

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