Table of ContentsView AllTable of ContentsCommon CausesGeneticsLifestyle Risk FactorsNext in Geographic Atrophy GuideHow Geographic Atrophy Is Diagnosed

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Table of Contents

Common Causes

Genetics

Lifestyle Risk Factors

Next in Geographic Atrophy Guide

Geographic atrophyoccurs in the late stage ofage-related macular degeneration(AMD). It is linked to several risk factors including advanced age, family history, and cigarette smoking.

This article will cover the most common risk factors for geographic atrophy, the role of genetics and lifestyle, as well as how these factors may make you more vulnerable to the condition.

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An older White male with a gray beard and glasses smoking a cigarette.

Scientists think that a variety of factors are at play. Age and family history are the most significant risk factors. If you have close relatives with a history of geographic atrophy, you might be more likely to get it.

Geneticsalso appears to play a role. For example, in some donor eyes with geographic atrophy, errors found in part of the immune system known as the complement cascade have been observed. If this system is not functioning correctly, inflammation can occur. In turn, the inflammation may make the eye more vulnerable to geographic atrophy.

Risk factors related to medical history include:

Age

The older you are, the more likely you are to develop geographic atrophy. The condition usually affects people over the age of 60.

It’s thought that cumulative damage can lead to chronic inflammation that ultimately causes the retinal cells to die. The retinal pigment epithelium does not regenerate quickly, leaving it particularly vulnerable to progressive cell loss over time.

The genes you have might be important in determining your risk for developing geographic atrophy, and they seem to have a connection to AMD in general. However, not all cases of AMD progress to late-stage geographic atrophy.

Four genetic variations, known as single nucleotide polymorphisms (SNPs), appear to play a role in the progression of late AMD to either geographic atrophy or another late complication known aschoroidal neovascularization(CNV).

In CNV, something spurs the eye to grow new—but abnormally leaky—blood vessels. With geographic atrophy, the structure of the retina begins to break down, and cells start to waste away.

Researchers have found that four SNPs seemed to be important to this process:

Malfunction of these SNPs may lead to the development of geographic atrophy or potentially to CNV.

Other genes are also thought to be related to geographic atrophy. For example, a gene variant called ARMS2 (rs10490924) may spur early AMD cases to become late ones as well as make the geographic atrophy lesions grow faster.

Researchers think that the gene might also be linked to the development of geographic atrophy in the second eye and causing these lesions to grow more quickly.

There could also be other genes involved in the risk of geographic atrophy that researchers have yet to identify.

Environmental stress from several factors may make you more vulnerable to geographic atrophy, including:

Smoking

Smoking can increase your risk of developing geographic atrophy. Chemicals that the body absorbs from smoking can travel to the retina and damage it. It’s thought that cigarette smoke irritates the cells, which in turn spurs theimmune systemto take action and cause harmful inflammation.

The act of smoking itself also causes the immune system’s complement cascade to turn on, which has been connected to AMD. This might be more harmful to some people than others, which points to a potential genetic link.

Summary

Common risk factors for geographic atrophy include smoking, older age, and a family history of the condition. While the exact genetic mechanism is not yet known, it is clear that there is a hereditary component. Having specific genes may make you more vulnerable to the condition.

Lifestyle factors such as your weight, having health conditions like heart disease or cataracts, and taking certain medications may increase your risk of geographic atrophy.

A Word From Verywell

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, et al.The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target.Retina. 2017;37(5):819-835. doi:10.1097/IAE.0000000000001392American Academy of Ophthalmology.Geographic atrophy.Wang W, Gawlik K, Lopez J, et al.Genetic and environmental factors strongly influence risk, severity and progression of age-related macular degeneration.Sig Transduct Target Ther.2016;1:16016. doi:10.1038/sigtrans.2016.16Seddon JM.Macular degeneration epidemiology: nature-nurture, lifestyle factors, genetic risk, and gene-environment interactions - the Weisenfeld Award lecture.Invest Ophthalmol Vis Sci. 2017;58(14):6513-6528. doi:10.1167/iovs.17-23544Bright Focus Foundation.Smoking and age-related macular degeneration.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, et al.The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target.Retina. 2017;37(5):819-835. doi:10.1097/IAE.0000000000001392American Academy of Ophthalmology.Geographic atrophy.Wang W, Gawlik K, Lopez J, et al.Genetic and environmental factors strongly influence risk, severity and progression of age-related macular degeneration.Sig Transduct Target Ther.2016;1:16016. doi:10.1038/sigtrans.2016.16Seddon JM.Macular degeneration epidemiology: nature-nurture, lifestyle factors, genetic risk, and gene-environment interactions - the Weisenfeld Award lecture.Invest Ophthalmol Vis Sci. 2017;58(14):6513-6528. doi:10.1167/iovs.17-23544Bright Focus Foundation.Smoking and age-related macular degeneration.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, et al.The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target.Retina. 2017;37(5):819-835. doi:10.1097/IAE.0000000000001392American Academy of Ophthalmology.Geographic atrophy.Wang W, Gawlik K, Lopez J, et al.Genetic and environmental factors strongly influence risk, severity and progression of age-related macular degeneration.Sig Transduct Target Ther.2016;1:16016. doi:10.1038/sigtrans.2016.16Seddon JM.Macular degeneration epidemiology: nature-nurture, lifestyle factors, genetic risk, and gene-environment interactions - the Weisenfeld Award lecture.Invest Ophthalmol Vis Sci. 2017;58(14):6513-6528. doi:10.1167/iovs.17-23544Bright Focus Foundation.Smoking and age-related macular degeneration.

Boyer DS, Schmidt-Erfurth U, van Lookeren Campagne M, et al.The pathophysiology of geographic atrophy secondary to age-related macular degeneration and the complement pathway as a therapeutic target.Retina. 2017;37(5):819-835. doi:10.1097/IAE.0000000000001392

American Academy of Ophthalmology.Geographic atrophy.

Wang W, Gawlik K, Lopez J, et al.Genetic and environmental factors strongly influence risk, severity and progression of age-related macular degeneration.Sig Transduct Target Ther.2016;1:16016. doi:10.1038/sigtrans.2016.16

Seddon JM.Macular degeneration epidemiology: nature-nurture, lifestyle factors, genetic risk, and gene-environment interactions - the Weisenfeld Award lecture.Invest Ophthalmol Vis Sci. 2017;58(14):6513-6528. doi:10.1167/iovs.17-23544

Bright Focus Foundation.Smoking and age-related macular degeneration.

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