This study, published in *JAMA Ophthalmology*, investigates the association between pegcetacoplan treatment and consensus features of geographic atrophy (GA) over a 24-month period. The research is based on post hoc analysis of 11,614 spectral-domain optical coherence tomography (SD-OCT) volumes from 936 participants in two phase 3 trials: OAKS and DERBY. Participants received either pegcetacoplan (15 mg per 0.1-mL intravitreal injection) monthly or every other month, or sham injections. The primary endpoint was the least squares mean change from baseline in the area of retinal pigment epithelium and outer retinal atrophy in each treatment arm. The results showed that pegcetacoplan, but not sham treatment, was associated with reduced growth rates of SD-OCT biomarkers for GA up to 24 months. Specifically, the least squares mean difference in the area of retinal pigment epithelium and outer retinal atrophy from baseline at month 24 was −0.86 mm² for the monthly pegcetacoplan group and −0.69 mm² for the every other month pegcetacoplan group, both statistically significant (P < .001). The study also found that pegcetacoplan treatment was more effective in reducing the growth rates of retinal pigment epithelium loss, hypertransmission, and photoreceptor degeneration compared to the sham group. These findings suggest that pegcetacoplan may have a protective effect on both photoreceptors and retinal pigment epithelium, which could be observed more readily than with retinal pigment epithelium loss alone. The study concludes that SD-OCT imaging can provide valuable insights into the growth and response to treatment of GA, offering additional evidence of the protective effects of pegcetacoplan. However, the study acknowledges limitations, including the inability to establish direct causal relationships due to its post hoc nature.This study, published in *JAMA Ophthalmology*, investigates the association between pegcetacoplan treatment and consensus features of geographic atrophy (GA) over a 24-month period. The research is based on post hoc analysis of 11,614 spectral-domain optical coherence tomography (SD-OCT) volumes from 936 participants in two phase 3 trials: OAKS and DERBY. Participants received either pegcetacoplan (15 mg per 0.1-mL intravitreal injection) monthly or every other month, or sham injections. The primary endpoint was the least squares mean change from baseline in the area of retinal pigment epithelium and outer retinal atrophy in each treatment arm. The results showed that pegcetacoplan, but not sham treatment, was associated with reduced growth rates of SD-OCT biomarkers for GA up to 24 months. Specifically, the least squares mean difference in the area of retinal pigment epithelium and outer retinal atrophy from baseline at month 24 was −0.86 mm² for the monthly pegcetacoplan group and −0.69 mm² for the every other month pegcetacoplan group, both statistically significant (P < .001). The study also found that pegcetacoplan treatment was more effective in reducing the growth rates of retinal pigment epithelium loss, hypertransmission, and photoreceptor degeneration compared to the sham group. These findings suggest that pegcetacoplan may have a protective effect on both photoreceptors and retinal pigment epithelium, which could be observed more readily than with retinal pigment epithelium loss alone. The study concludes that SD-OCT imaging can provide valuable insights into the growth and response to treatment of GA, offering additional evidence of the protective effects of pegcetacoplan. However, the study acknowledges limitations, including the inability to establish direct causal relationships due to its post hoc nature.