AREDS Data Analysis Explores Visual Function Decline After Developing GA

This study found worsening QOL after GA development in AREDS participants across several measures, highlighting the importance of examining the relationship between GA subtypes and patient-reported measures of visual impact. Click image to enlarge. Geographic atrophy (GA) can profoundly impact patients’ vision-related quality of life (VRQOL), but surprisingly few studies have evaluated the change in vision- or health-related QOL after its development. Recently, researchers examined this change among AREDS participants who completed the NEI’s Visual Function Questionnaire-25 during at least two study visits one year apart. They observed worsening QOL after development of GA across several measures—more so in visual functioning than in socioemotional functioning. The findings were reported in Ophthalmology Science.A masked reading center assessed AMD severity using annual color fundus photos, then compared the rate of change in QOL using separate models for GA subtypes: central GA, noncentral GA and any GA.Among the cohort, 358 eyes (298 participants) developed GA. Regarding GA subtypes, none of the VRQOL measures differed significantly pre- and post-central GA. However, visual function and composite scores declined more quickly after noncentral GA and after any GA. The lack of significant associations with central GA was likely due to the small sample size of eyes, the authors noted, and these results demonstrate that the larger areas of GA are independently associated with worse VRQOL.“Considering that patients with central GA are likely to have worse visual acuity than patients with noncentral GA, future studies with a larger sample size may demonstrate a significant difference in the rate of decline of VRQOL among patients with central GA,” the authors wrote in their paper. However, a previous study also hypothesized that patients may adapt to the changes in their vision from the gradual progression of central GA, which may explain the similar rate of VRQOL before and after the development of central GA.They also found that the area of GA—but not proximity to fovea or noncircularity index—was associated with the rate of decline of VRQOL scores. For every 1mm² increase in noncentral GA area, the composite score decreased by 0.52 points. This aligns with prior studies that also reported an association between GA area and worse VRQOL scores and can be explained by the natural progression and pathophysiology of GA, which involves a gradually enlarging area of atrophic RPE over time. These results may have implications for patient counseling regarding the impact of the development on GA on activities of daily living that require visual input, the researchers contend. “Future studies could investigate factors that may underlie the difference in results between central GA and noncentral GA reported in our study,” they concluded.Click here for the journal source. Prasad M, Vitale S, Agron E, et al. Changes in vision-related quality of life before and after geographic atrophy development in Age-related Eye Disease Study participants. Ophthalmol Sci. November 19, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.