Retinal dystrophies simulating geographic atrophy: A diagnostic challenge

Geographic atrophy (GA) is the chronic loss of retinal pigment epithelium, photoreceptors and choriocapillaris, marking the dry late stage of age-related macular degeneration (AMD). GA prevalence is expected to rise in the upcoming decades. Advanced GA leads to central scotomas, reducing visual acuity and quality of life, potentially resulting in profound central vision loss. GA shares features with various retinal diseases and can therefore be complicated to distinguish from mimicking diseases. While no cure exists for GA, therapies like pegcetacoplan and avacincaptad aim to slow atrophy growth, making an accurate diagnosis essential for effective treatment. Misdiagnosis can lead to inappropriate treatment recommendations, impacting patient health and financial burden. This paper outlines the similarities and differences among prevalent diseases such as late-onset Stargardt disease, PRPH2-associated disease and maternally inherited diabetes and deafness (MIDD), resembling GA to aid in accurate diagnosis.