For patients with geographic atrophy, the advanced form of dry age-related macular degeneration, there is genuinely good news. For the first time in Australia, two treatments are available that have been shown in clinical trials to slow the progression of this condition. Neither treatment reverses damage that has already occurred, but both offer the possibility of preserving more vision for longer than would otherwise be the case. This post explains what these treatments are, who may be eligible, and what patients should discuss with their ophthalmologist.
What is geographic atrophy?
Geographic atrophy occurs when the cells at the back of the eye responsible for central vision progressively die, leaving patches of retina with no remaining function. It is the advanced stage of dry AMD and causes a gradual loss of the central vision needed for reading, recognising faces, and driving. It is different from wet AMD, where abnormal blood vessels cause rapid vision loss, though both can occur in the same eye at different times.
Until recently, there was no treatment available to slow geographic atrophy. Management was limited to monitoring, AREDS2 nutritional supplementation for eligible patients, lifestyle advice, and low vision support. That has changed.
What are the new treatments?
Two complement-inhibitor therapies are now TGA-approved in Australia for geographic atrophy.
Pegcetacoplan (Syfovre, Apellis Pharmaceuticals) was approved by the TGA in January 2025, making Australia the first country outside the United States to have access to this treatment. It is given as an injection into the eye every other month.
Avacincaptad pegol (Izervay, Astellas Pharma) was approved by the TGA in October 2025. It is given as a monthly injection into the eye.
Both treatments work by dampening down a part of the immune system called the complement pathway, which is thought to drive the progressive death of retinal cells in geographic atrophy. Both are given in the same way as anti-VEGF injections for wet AMD.
For a detailed clinical explanation of how these treatments work, the evidence behind them, and eligibility criteria, see the full guide to geographic atrophy treatment in Australia at corneaeyedoctor.com.
What do the treatments achieve?
The clinical trials for both treatments showed that they slow the rate at which geographic atrophy lesions grow. This means that treated patients lose retinal tissue more slowly than they would without treatment, preserving functional vision for longer.
It is important to have realistic expectations. These treatments do not restore vision that has already been lost. They do not cure geographic atrophy. The benefit is in slowing the trajectory of further loss, which over years can make a meaningful difference to how much vision is preserved.
Patients considering treatment need to understand that the benefit may not be apparent as an improvement in their vision test results in the short term. The goal is preservation, not improvement.
Who may be eligible?
Both treatments are approved for patients with geographic atrophy who still have intact central vision and where the lesions are growing toward the fovea and threatening that central vision. Patients whose central vision has already been destroyed by geographic atrophy are outside the approved indication.
A full assessment including OCT imaging and fundus autofluorescence is required to determine eligibility. Your ophthalmologist will assess the size, location, and growth rate of your GA lesions before discussing whether treatment is appropriate for your individual situation.
Are the treatments covered by Medicare or private health insurance?
Neither treatment is currently listed on the Pharmaceutical Benefits Scheme (PBS), which means they are not subsidised by Medicare. Treatment is entirely self-funded at this stage. The cost is significant and varies. PBS listing is being actively pursued and may occur in the coming years, which would substantially reduce costs for eligible patients.
We recommend discussing the current cost and access options with your ophthalmologist before making any decision. There is no obligation to proceed with treatment, and the decision should be made with a clear understanding of both the potential benefit and the financial commitment involved.
What else should patients with dry AMD be doing?
While the new treatments are a significant advance, existing recommendations remain important.
AREDS2 nutritional supplementation (a specific combination of vitamins C and E, lutein, zeaxanthin, and zinc) has been shown to reduce the risk of progression from intermediate AMD to advanced AMD by approximately 25 percent and is recommended for eligible patients regardless of whether complement-inhibitor therapy is being considered.
Amsler grid monitoring at home allows patients to detect any new distortion or change in their central vision between appointments. Any new change should prompt an urgent review rather than waiting for a scheduled appointment, as it may signal conversion to wet AMD which requires prompt treatment.
Lifestyle measures including not smoking, wearing sunglasses, and managing cardiovascular risk factors all contribute to reducing the risk of AMD progression.
How do I find out if I am eligible for treatment?
If you have been diagnosed with geographic atrophy or dry AMD and would like to discuss whether the new treatments are appropriate for you, the first step is a consultation with an ophthalmologist who manages macular disease. A referral from your GP or optometrist is required. Referrals can be addressed to our subspecialist team at Northern Eye Consultants, Northpark Private Hospital, Bundoora.
Northern Eye Consultants provides assessment and treatment for a broad range of eye conditions, including other conditions we manage such as posterior capsule opacification following cataract surgery. Contact our rooms to discuss your situation or to arrange a consultation.
For detailed procedure guides and patient information from Dr MacIntyre, visit drmacintyre.com.