One-Year Results of Geographic Atrophy Patients with Pre-Existing nAMD treated with both anti-VEGF therapy and pegcetacoplan.

Purpose: To examine geographic atrophy (GA) progression in patients receiving pegcetacoplan injections with pre-existing 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 co-existing 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 (OCT), infrared reflectance (IR) data, fundus autofluorescence, and fundus photography were used to measure GA area at five time points: 1 year before pegcetacoplan initiation, then every 6 months until 1 year after pegcetacoplan initiation. Longitudinal change in GA area was analyzed using a linear mixed-effects model (LMM) with square-root transformed GA area to account for repeated measurements within eyes. Visual acuity (VA) was recorded and converted to 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 weeks 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 < 0.0001). VA remained stable, starting at 67.5 letters, increasing to 67.9 letters after 2 years (p = 0.93). Conclusion: Concurrent anti-VEGF and pegcetacoplan therapy was associated with an overall reduction in GA lesion growth rate and stabilized nAMD.