{ "abstract": "Background: Geographic atrophy (GA), an advanced form of age-related macular degeneration (AMD), leads to legal blindness in approximately 16% of affected individuals within 6 years. Numerous trials have evaluated interventions to slow GA progression, and many studies are ongoing. However, the comparative benefits and harms of treatments within this rapidly evolving therapeutic landscape have not yet been systematically synthesized. Objectives: To present a protocol for a living systematic review and network meta-analysis (NMA) addressing the effects of available interventions for the management of GA. Methods: We systematically searched Medline, EMBASE, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov from inception for randomized controlled trials comparing any pharmacologic or non-pharmacologic treatment versus another, placebo, sham, or standard care in adults with unilateral or bilateral GA secondary to AMD. Paired reviewers will independently screen studies, extract data, and assess risk of bias. Outcomes of interest include best-corrected visual acuity (BCVA), untransformed and square root-transformed total GA lesion area, vision-related quality of life, low luminance BCVA, reading speed, mean macular sensitivity, adverse events leading to discontinuation, macular neovascularization, need for rescue treatment, ischemic optic neuropathy, serious ocular adverse events, and serious non-ocular adverse events. For each outcome, if feasible, we will conduct frequentist random-effects NMAs. We will assess the certainty of evidence and interpret findings using the GRADE approach. To maintain this review as a living systematic review, we will conduct updates every six months. Discussion: This review will provide a comprehensive, trustworthy, and up-to-date summary of evidence on treatments for GA secondary to AMD. Registration: Open Science Framework (https://doi.org/10.17605/OSF.IO/W4JHR).", "abstract_shown": true, "affiliations": [ "Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada", "Thomas Kevill Advanced Vitreoretinal Imaging (AVI) Lab, St Joseph’s Healthcare, Hamilton, Ontario, Canada", "Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada", "Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada", "NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom", "Department of Surgical Sciences, University of Turin, Turin, Italy", "Department of Ophthalmology, “City of Health and Science” Hospital, Turin, Italy", "Cole Eye Institute, Cleveland Clinic, Euclid Avenue, Cleveland, Ohio, United States of America", "Sunderland Eye Infirmary, National Health Service, Sunderland, United Kingdom", "Biosciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom", "Singapore Eye Research Institute, Singapore National Eye Centre, SingaporeSingapore", "Beijing Visual Science and Translational Eye Research Institute, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China" ], "article_type": "Study Protocol", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Maryam Ghadimi" }, { "affs": [ 1 ], "name": "Housne Begum" }, { "affs": [ 2 ], "name": "Dena Zeraatkar" }, { "affs": [ 3 ], "name": "Jinhui Ma" }, { "affs": [ 4 ], "name": "Sobha Sivaprasad" }, { "affs": [ 5 ], "name": "Enrico Borrelli" }, { "affs": [ 6 ], "name": "Peter Kaiser" }, { "affs": [ 7 ], "name": "David H. Steel" }, { "affs": [ 8 ], "name": "Tien Yin Wong" }, { "affs": [ 9 ], "name": "Robyn Guymer" }, { "affs": [ 10 ], "name": "Charles C. Wykoff" }, { "affs": [ 11 ], "name": "Varun Chaudhary" } ], "bibtex": "https://research.draconitic.com/paper/28m85ec2gh92q.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0358699", "fulltext_url": null, "id": "28m85ec2gh92q", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0358699", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2731|Retinal Diseases and Treatments" ], [ "plos", "/Biology and life sciences/Anatomy/Head/Eyes" ], [ "plos", "/Biology and life sciences/Anatomy/Ocular system/Eyes" ], [ "plos", "/Biology and life sciences/Biochemistry/Proteins/Immune system proteins/Complement system/Complement inhibitors" ], [ "plos", "/Biology and life sciences/Immunology/Immune system proteins/Complement system/Complement inhibitors" ], [ "plos", "/Biology and life sciences/Immunology/Immune system/Complement system/Complement inhibitors" ], [ "plos", "/Biology and life sciences/Physiology/Immune physiology/Complement system/Complement inhibitors" ], [ "plos", "/Computer and information sciences/Network analysis" ], [ "plos", "/Medicine and health sciences/Anatomy/Head/Eyes" ], [ "plos", "/Medicine and health sciences/Anatomy/Ocular system/Eyes" ], [ "plos", "/Medicine and health sciences/Epidemiology/Medical risk factors" ], [ "plos", "/Medicine and health sciences/Geriatrics/Geriatric ophthalmology/Macular degeneration" ], [ "plos", "/Medicine and health sciences/Immunology/Immune system proteins/Complement system/Complement inhibitors" ], [ "plos", "/Medicine and health sciences/Immunology/Immune system/Complement system/Complement inhibitors" ], [ "plos", "/Medicine and health sciences/Medical conditions/Eye diseases/Retinal disorders/Macular disorders/Macular degeneration" ], [ "plos", "/Medicine and health sciences/Medical conditions/Eye diseases/Retinal disorders/Retinal degeneration/Macular degeneration" ], [ "plos", "/Medicine and health sciences/Ophthalmology/Eye diseases/Retinal disorders/Macular disorders/Macular degeneration" ], [ "plos", "/Medicine and health sciences/Ophthalmology/Eye diseases/Retinal disorders/Retinal degeneration/Macular degeneration" ], [ "plos", "/Medicine and health sciences/Ophthalmology/Geriatric ophthalmology/Macular degeneration" ], [ "plos", "/Medicine and health sciences/Pharmaceutics/Drug therapy/Antioxidant therapy" ], [ "plos", "/Physical sciences/Mathematics/Statistics/Statistical methods/Metaanalysis" ], [ "plos", "/Research and analysis methods/Mathematical and statistical techniques/Statistical methods/Metaanalysis" ], [ "plos", "/Research and analysis methods/Research assessment/Systematic reviews" ] ], "openalex": "W7127917610", "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0358699&type=printable", "pmcid": null, "pmid": null, "published": "2026-09-30", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/28m85ec2gh92q.ris", "sources": [ { "first_seen": "2026-10-30T12:17:37Z", "native_id": "10.1371/journal.pone.0358699", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0358699" } ], "subjects": [ { "field": "biology", "origin": "plos:immunology", "subfield": "immunology" }, { "field": "medicine", "origin": "plos:anatomy", "subfield": "physiology" } ], "title": "OphthoEvidence Report: Comparative effects of treatments for geographic atrophy secondary to age-related macular degeneration: A protocol for a living systematic review and network meta-analysis", "title_text": "OphthoEvidence Report: Comparative effects of treatments for geographic atrophy secondary to age-related macular degeneration: A protocol for a living systematic review and network meta-analysis", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:37Z", "url": "https://research.draconitic.com/paper/28m85ec2gh92q", "venue": "PLOS One", "versions": [] }