Abstract
Purpose:
To examine geographic atrophy (GA) progression in patients receiving pegcetacoplan injections with preexisting neovascular age-related macular degeneration (nAMD) treated previously and concurrently with anti-VEGF (vascular endothelial growth factor) injections.
Methods:
Retrospective cohort study of 31 nAMD and coexisting GA patients from March 2023 to July 2025. Inclusion criteria were previous anti-VEGF treatment for ≥1 year and concurrent anti-VEGF and pegcetacoplan treatments in the following year. Subfoveal GA patients were excluded. Spectral-domain optical coherence tomography, infrared reflectance data, fundus autofluorescence, and fundus photography were used to measure GA area at five time points: 1 year before pegcetacoplan initiation and then every 6 months until 1 year after pegcetacoplan initiation. Longitudinal change in GA area was analyzed using a linear mixed-effects model with square-root transformed GA area to account for repeated measurements within eyes. Visual acuity was recorded and converted to Early Treatment Diabetic Retinopathy Study (ETDRS) letters for analysis.
Results:
Twelve patients were male and 19 female, with an average age of 87.2 years. Mean anti-VEGF treatment interval was 11.8 weeks, and 8.1 week for pegcetacoplan. Average treatment duration of nAMD was 6.5 years. Square-root transformed GA area increased +0.39 mm from −1 year to pegcetacoplan initiation, then +0.22 mm from initiation to +1 year, a 44% decrease in GA growth rate (
P
P
= 0.93).
Conclusion:
Concurrent anti-VEGF and pegcetacoplan therapy was associated with an overall reduction in GA lesion growth rate and stabilized nAMD.