Objective:

To evaluate the visual function outcomes of treatments for geographic atrophy (GA) and discuss the specific limitations of current assessment tools, such as their inability to detect meaningful changes in visual function.

Key Findings:

• Recent therapies for GA show reduced growth rates but no significant improvement in visual function endpoints, raising questions about their clinical utility.
• Visual acuity and reading speed are limited in reflecting the overall functional impact of GA, potentially misleading treatment assessments.
• Defect-mapping microperimetry (DMP) captures visual sensitivity loss more effectively than conventional methods, suggesting a need for its broader adoption in clinical trials.

Interpretation:

The absence of significant treatment effects on visual function endpoints may reflect the limitations of the assessment tools rather than a lack of functional benefit from the treatments, indicating a need for improved measurement strategies.

Limitations:

• Current visual function measures are underpowered to detect meaningful changes in GA, complicating the interpretation of trial results and clinical decisions.
• Measurement variability in visual function assessments complicates the interpretation of trial results, potentially leading to underestimation of treatment benefits.

Conclusion:

Optimizing testing strategies, such as using DMP and incorporating additional functional measures, could provide better insights into the functional benefits of GA treatments.