{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:28:51Z","timestamp":1786969731080,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010810","name":"\u00d6gonfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010810","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Fovea\u2010sparing geographic atrophy (GA) patients retain near\u2010normal central vision. To better understand GA progression in relation to the fovea, we performed a semi\u2010automated image analysis of regional atrophy growth in a long\u2010term GA natural\u2010history cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective\u2010observational, single\u2010centre\u2010study (02\/2013\u201307\/2025) at the Division of Eye and Vision, Karolinska Institutet\/St. Erik Eye Hospital, Stockholm, Sweden. Longitudinal square\u2010root\u2010transformed GA area and distance\u2010growth rates [mm\/year] in all retinal quadrants were calculated from fundus autofluorescence images. Eyes were stratified based on best\u2010corrected visual acuity: fovea\u2010sparing (\u226565 ETDRS) and fovea\u2010involving (&lt;65 ETDRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      65 eyes (65 patients) presented fovea\u2010sparing and 91 eyes (91 patients) fovea\u2010involving. Median follow\u2010up was 18\u2009months (range: 5\u2013125). The fovea\u2010involving group decreased in BCVA (Wilcoxon,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Total area growth was faster for fovea\u2010sparing than fovea\u2010involving lesions: 0.34 vs. 0.26 (Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0019). The same was true for the superior, inferior, and temporal quadrants (Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      , all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0472). Fovea\u2010sparing lesions showed slower distance growth towards the fovea than outwards in all quadrants: superior 0.09 vs. 0.21; nasal 0.08 vs. 0.18; inferior 0.06 vs. 0.17; temporal 0.09 vs. 0.20 (Wilcoxon, all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Lesions closer to the fovea (\u2264500\u2009\u03bcm) at baseline showed decreased regional growth towards the fovea. Outwards growth was not related to lesion location.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this longitudinal cohort, fovea\u2010sparing lesions showed faster total and regional growth than fovea\u2010involving lesions, mainly caused by a faster outward expansion component. Location 500\u2009\u03bcm or closer to the fovea resulted in slower growth, which supports a foveal self\u2010protecting mechanism. These are relevant findings for patients with fovea\u2010sparing lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.70229","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:10:43Z","timestamp":1786968643000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Regional growth kinetics of geographic atrophy in age\u2010related macular degeneration with and without fovea\u2010sparing"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3670-976X","authenticated-orcid":false,"given":"Daniel R.","family":"Muth","sequence":"first","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"St. Erik Eye Hospital  Solna Sweden"},{"name":"Department of Ophthalmology University Hospital Zurich, University of Zurich  Zurich Switzerland"},{"name":"Department of Ophthalmology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abinaya P.","family":"Venkataraman","sequence":"additional","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8861-7843","authenticated-orcid":false,"given":"Alberto","family":"Dominguez\u2010Vicent","sequence":"additional","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2905-9252","authenticated-orcid":false,"given":"Goran","family":"Petrovski","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Oslo University Hospital  Oslo Norway"},{"name":"Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Ophthalmology University of Split School of Medicine and University Hospital Centre  Split Croatia"},{"name":"UKLO Network, University St. Kliment Ohridski\u2010Bitola  Bitola North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pete A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"St. Erik Eye Hospital  Solna Sweden"},{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8878-1600","authenticated-orcid":false,"given":"Laurence","family":"Qu\u00e9rat","sequence":"additional","affiliation":[{"name":"St. Erik Eye Hospital  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Locri","sequence":"additional","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine A.","family":"Zweifel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Zurich, University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Kvanta","sequence":"additional","affiliation":[{"name":"Division of Eye and Vision, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"St. Erik Eye Hospital  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"5535","DOI":"10.1167\/iovs.13-12250","article-title":"Lack of correlation between the spatial distribution of A2E and lipofuscin fluorescence in the human retinal pigment epithelium","volume":"54","author":"Ablonczy Z.","year":"2013","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1021\/jasms.0c00119","article-title":"Lipid landscape of the human retina and supporting tissues revealed by high\u2010resolution imaging mass spectrometry","volume":"31","author":"Anderson D.M.G.","year":"2020","journal-title":"Journal of the American Society for Mass Spectrometry"},{"key":"e_1_2_9_4_1","unstructured":"Apellis Pharmaceuticals Inc. (2023)Apellis Provides Update on Ongoing Regulatory Review of Pegcetacoplan for GA in the European Union."},{"key":"e_1_2_9_5_1","unstructured":"Astellas Pharma Inc. (2024)Astellas Provides Update on Marketing Authorization Application for Avacincaptad Pegol (ACP) in the European Union."},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1167\/iovs.63.2.8","article-title":"Human Foveal cone and RPE cell topographies and their correspondence with Foveal shape","volume":"63","author":"Baraas R.C.","year":"2022","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/BF00175988","article-title":"Improvements on Littmann's method of determining the size of retinal features by fundus photography","volume":"232","author":"Bennett A.G.","year":"1994","journal-title":"Graefe's Archive for Clinical and Experimental Ophthalmology"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1167\/iovs.61.5.35","article-title":"Autofluorescent granules of the human retinal pigment epithelium: phenotypes, intracellular distribution, and age\u2010related topography","volume":"61","author":"Bermond K.","year":"2020","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.abb.2008.09.012","article-title":"Retinal carotenoids can attenuate formation of A2E in the retinal pigment epithelium","volume":"483","author":"Bhosale P.","year":"2009","journal-title":"Archives of Biochemistry and Biophysics"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1111\/aos.70210","article-title":"Systematic quantification of outer retinal morphology in three different SD\u2010OCT devices in geographic atrophy","author":"Birner K.","year":"2026","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1038\/eye.2001.141","article-title":"The role of the retinal pigment epithelium: topographical variation and ageing changes","volume":"15","author":"Boulton M.","year":"2001","journal-title":"Eye (London, England)"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1038\/s41433-024-03443-0","article-title":"Age\u2010related macular degeneration: natural history revisited in geographic atrophy","volume":"39","author":"Broadbent E.","year":"2025","journal-title":"Eye (London, England)"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.oret.2024.07.025","article-title":"The discrepancy between visual acuity decline and Foveal involvement in geographic atrophy","volume":"9","author":"Cicinelli M.V.","year":"2025","journal-title":"Ophthalmology Retina"},{"key":"e_1_2_9_14_1","first-page":"1236","article-title":"Photoreceptor loss in age\u2010related macular degeneration","volume":"37","author":"Curcio C.A.","year":"1996","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1002\/cne.902920402","article-title":"Human photoreceptor topography","volume":"292","author":"Curcio C.A.","year":"1990","journal-title":"The Journal of Comparative Neurology"},{"key":"e_1_2_9_16_1","first-page":"718","article-title":"In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics","volume":"36","author":"Delori F.C.","year":"1995","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"e204","DOI":"10.1111\/aos.17431","article-title":"Photoreceptor\u2010RPE loss ratio and fundus autofluorescence patterns as predictive factors for lesion progression in geographic atrophy","volume":"103","author":"Egger D.","year":"2025","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_9_18_1","unstructured":"European Medicines Agency (EMA). (2024)Refusal of the marketing authorisation for Syfovre (pegcetacoplan) \u2013 Re\u2010examination confirms refusal."},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0002-9394(82)90197-0","article-title":"New visual acuity charts for clinical research","volume":"94","author":"Ferris F.L.","year":"1982","journal-title":"American Journal of Ophthalmology"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.ophtha.2017.08.038","article-title":"The progression of geographic atrophy secondary to age\u2010related macular degeneration","volume":"125","author":"Fleckenstein M.","year":"2018","journal-title":"Ophthalmology"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"5705","DOI":"10.1167\/iovs.18-24677","article-title":"Human retinal pigment epithelium: in\u00a0vivo cell morphometry, multispectral autofluorescence, and relationship to cone mosaic","volume":"59","author":"Granger C.E.","year":"2018","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_22_1","unstructured":"Heidelberg Engineering. (2022)SPECTRALIS Product Family Hardware Manual (for devices bought or upgraded in 2022\u201309 and later)."},{"key":"e_1_2_9_23_1","unstructured":"Heidelberg Engineering. (2024)HEYEX User Manual V.1.12.4."},{"key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s004170050209","article-title":"Patterns of increased in\u00a0vivo fundus autofluorescence in the junctional zone of geographic atrophy of the retinal pigment epithelium associated with age\u2010related macular degeneration","volume":"237","author":"Holz F.G.","year":"1999","journal-title":"Graefe's Archive for Clinical and Experimental Ophthalmology"},{"key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1056\/NEJMoa2501396","article-title":"Subretinal photovoltaic implant to restore vision in geographic atrophy due to AMD","volume":"394","author":"Holz F.G.","year":"2026","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_9_26_1","first-page":"493","article-title":"Updates on the epidemiology of age\u2010related macular degeneration","volume":"6","author":"Jonas J.B.","year":"2017","journal-title":"Asia\u2010Pacific Journal of Ophthalmology"},{"key":"e_1_2_9_27_1","doi-asserted-by":"crossref","first-page":"4932","DOI":"10.1167\/iovs.12-9711","article-title":"Topography of geographic atrophy in age\u2010related macular degeneration","volume":"53","author":"Mauschitz M.M.","year":"2012","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_9_28_1","doi-asserted-by":"crossref","DOI":"10.1167\/tvst.14.5.5","article-title":"Long\u2010term natural history of treatment\u2010naive geographic atrophy in age\u2010related macular degeneration","volume":"14","author":"Muth D.R.","year":"2025","journal-title":"Translational Vision Science & Technology"},{"key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1016\/j.ophtha.2006.12.023","article-title":"Cone\u2010 and rod\u2010mediated dark adaptation impairment in age\u2010related maculopathy","volume":"114","author":"Owsley C.","year":"2007","journal-title":"Ophthalmology"},{"key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1097\/IAE.0000000000001283","article-title":"Clinical endpoints for the study of geographic atrophy secondary to age\u2010related macular degeneration","volume":"36","author":"Sadda S.R.","year":"2016","journal-title":"Retina"},{"key":"e_1_2_9_31_1","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1038\/nmeth.2019","article-title":"Fiji: an open\u2010source platform for biological\u2010image analysis","volume":"9","author":"Schindelin J.","year":"2012","journal-title":"Nature Methods"},{"key":"e_1_2_9_32_1","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/S0161-6420(99)90340-8","article-title":"Enlargement of atrophy and visual acuity loss in the geographic atrophy form of age\u2010related macular degeneration","volume":"106","author":"Sunness J.S.","year":"1999","journal-title":"Ophthalmology"},{"key":"e_1_2_9_33_1","doi-asserted-by":"crossref","DOI":"10.1111\/aos.70151","article-title":"Junctional sensitivity and atrophy progression rate of geographic atrophy secondary to age\u2010related macular degeneration","author":"Thomsen A.K.","year":"2026","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_9_34_1","doi-asserted-by":"crossref","DOI":"10.1111\/aos.70119","article-title":"The optical coherence tomography and microperimetry biomarker evaluation in patients with geographic atrophy (OMEGA) study: geographic atrophy progression in fundus autofluorescence \u2013 OMEGA report 3","author":"Valmaggia P.","year":"2026","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_9_35_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.oret.2022.08.003","article-title":"Predicting topographic disease progression and treatment response of Pegcetacoplan in geographic atrophy quantified by deep learning","volume":"7","author":"Vogl W.D.","year":"2023","journal-title":"Ophthalmology Retina"},{"key":"e_1_2_9_36_1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/aos.15767","article-title":"Epidemiology of geographic atrophy and its precursor features of intermediate age\u2010related macular degeneration","volume":"101","author":"Vujosevic S.","year":"2023","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_9_37_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1167\/jov.21.3.9","article-title":"Mapping the binocular scotoma in macular degeneration","volume":"21","author":"Vullings C.","year":"2021","journal-title":"Journal of Vision"},{"key":"e_1_2_9_38_1","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1016\/S2214-109X(13)70145-1","article-title":"Global prevalence of age\u2010related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta\u2010analysis","volume":"2","author":"Wong W.L.","year":"2014","journal-title":"The Lancet Global Health"},{"key":"e_1_2_9_39_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.xops.2025.100916","article-title":"Assessing the relationship between Foveal cone density, outer nuclear layer thickness and Foveal morphology","volume":"6","author":"Zacharias S.","year":"2026","journal-title":"Ophthalmology Science"},{"key":"e_1_2_9_40_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.xops.2025.101028","article-title":"Longitudinal study of macular preservation and geographic atrophy progression in age\u2010related eye disease study 2","volume":"6","author":"Zhang S.","year":"2026","journal-title":"Ophthalmology Science"},{"key":"e_1_2_9_41_1","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S0042-6989(03)00038-5","article-title":"Filling\u2010in of retinal scotomas","volume":"43","author":"Zur D.","year":"2003","journal-title":"Vision Research"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.70229","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aos.70229","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.70229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:10:48Z","timestamp":1786968648000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.70229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":40,"alternative-id":["10.1111\/aos.70229"],"URL":"https:\/\/doi.org\/10.1111\/aos.70229","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"value":"1755-375X","type":"print"},{"value":"1755-3768","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"assertion":[{"value":"2026-04-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aos.70229"}}