Purpose: To investigate the prevalence of geographic atrophy (GA) in advanced age-related
macular degeneration (AMD) and the proportion of eyes that would meet the indication criteria
for treatment with the first intravitreal anti-C3 agent (pegcetacoplan). Methods: This retrospective
cross-sectional study included all AMD patients who visited the Macular-Retina-Centre Oberkassel
in 2021. Eyes were classified according to AMD stages. Eyes with GA were divided into two groups
regarding foveal involvement. Baseline factors were compared between eyes with foveal GA (FGA)
and eyes with non-foveal GA (NFGA) to identify predictive factors for foveal involvement. Results:
A total of 2033 eyes from 1027 patients were included. AMD stage was early in 296 (14.5%) cases,
intermediate in 368 (18.1%) cases, and advanced in 1249 (61.4%) cases. A total of 1204 (60%) eyes
had GA [932 (77%) FGA and 272 (23%) NFGA], while 125 eyes (27.4% from eyes with advanced dry
AMD) met the indication criteria for treatment with intravitreal pegcetacoplan. The proportion of
eyes with neovascular AMD was significantly higher in the FGA group compared to the NFGA group
[598 (64.2%) vs. 152 (55.8%), p = 0.01]. Conclusions: At least a quarter of eyes with advanced AMD
would be suitable for the upcoming intravitreal pegcetacoplan therapy. Foveal involvement of GA in
advanced AMD seems to be more likely in neovascular AMD than in dry AMD