Atrophic AMD

Atrophy can occur in sharply defined areas of severe atrophy, known as geographic atrophy (GA), or in less well-defined, more granular regions of less severe atrophy, known as non-GA.

Both forms share the feature of RPE loss, more extensive and with associated atrophy of the overlying retina and underlying choriocapillaris in GA.

The angiographic appearance depends on the remaining pigment within the RPE and choriocapillaris vessels.

Non-GA shows mottled early hyperfluorescence, which fades late consistent with window defect (Fig. 5).

GA typically shows late well-defined hyperfluorescence from staining of the exposed deep choroid and sclera⁽⁹⁾.

In these cases, visual acuity depends on the foveal involvement (Fig. 6).

In advanced cases, larger choroidal vessels show a sclerotic appearance (Fig. 7).