This study evaluates the association between pegcetacoplan treatment and consensus spectral-domain optical coherence tomography (SD-OCT) features of geographic atrophy (GA) over 24 months. The research analyzed 11,614 SD-OCT volumes from 936 participants in two phase 3 clinical trials, OAKS and DERBY, which assessed the efficacy and safety of intravitreal pegcetacoplan in patients with GA secondary to age-related macular degeneration (AMD). The primary outcome was the least squares mean change in the area of retinal pigment epithelium (RPE) and outer retinal atrophy (RORA) in each of the three treatment arms (pegcetacoplan monthly, pegcetacoplan every other month, and pooled sham). The results showed that pegcetacoplan significantly reduced the growth rates of GA biomarkers compared to sham treatment. The most pronounced reductions were observed in the parafoveal and perifoveal regions. Pegcetacoplan monthly treatment showed greater reductions in GA area compared to every other month treatment. The study also found that pegcetacoplan treatment was associated with delayed atrophy of both RPE and photoreceptors. However, no significant association was found between pegcetacoplan treatment and changes in best-corrected visual acuity (BCVA). The findings suggest that pegcetacoplan may be effective in slowing the progression of GA. The study highlights the importance of SD-OCT in assessing GA progression and the potential of automated quantitative OCT analyses in GA diagnosis and monitoring. The study also discusses the limitations of using FAF imaging for GA assessment and the need for more detailed imaging techniques. The study concludes that pegcetacoplan may offer protective effects against GA progression, particularly in the parafoveal and perifoveal regions. The study is part of a larger effort to understand the pathophysiology of GA and to develop effective treatments for AMD.This study evaluates the association between pegcetacoplan treatment and consensus spectral-domain optical coherence tomography (SD-OCT) features of geographic atrophy (GA) over 24 months. The research analyzed 11,614 SD-OCT volumes from 936 participants in two phase 3 clinical trials, OAKS and DERBY, which assessed the efficacy and safety of intravitreal pegcetacoplan in patients with GA secondary to age-related macular degeneration (AMD). The primary outcome was the least squares mean change in the area of retinal pigment epithelium (RPE) and outer retinal atrophy (RORA) in each of the three treatment arms (pegcetacoplan monthly, pegcetacoplan every other month, and pooled sham). The results showed that pegcetacoplan significantly reduced the growth rates of GA biomarkers compared to sham treatment. The most pronounced reductions were observed in the parafoveal and perifoveal regions. Pegcetacoplan monthly treatment showed greater reductions in GA area compared to every other month treatment. The study also found that pegcetacoplan treatment was associated with delayed atrophy of both RPE and photoreceptors. However, no significant association was found between pegcetacoplan treatment and changes in best-corrected visual acuity (BCVA). The findings suggest that pegcetacoplan may be effective in slowing the progression of GA. The study highlights the importance of SD-OCT in assessing GA progression and the potential of automated quantitative OCT analyses in GA diagnosis and monitoring. The study also discusses the limitations of using FAF imaging for GA assessment and the need for more detailed imaging techniques. The study concludes that pegcetacoplan may offer protective effects against GA progression, particularly in the parafoveal and perifoveal regions. The study is part of a larger effort to understand the pathophysiology of GA and to develop effective treatments for AMD.