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Ophthalmology. 2017 Dec;124(12):1753-1763. doi: 10.1016/j.ophtha.2017.05.035. Epub 2017 Jul 14.

Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future.

Collaborators (139)

Ajana S, Arango-Gonzalez B, Arndt V, Bhatia V, Bhattacharya SS, Biarnés M, Borrell A, Bühren S, Calado SM, Colijn JM, Cougnard-Grégoire A, Dammeier S, de Jong EK, De la Cerda B, Delcourt C, den Hollander AI, Diaz-Corrales FJ, Diether S, Emri E, Endermann T, Ferraro LL, Garcia M, Heesterbeek TJ, Honisch S, Hoyng CB, Kersten E, Kilger E, Klaver CCW, Langen H, Lengyel I, Luthert P, Maugeais C, Meester-Smoor M, Merle BMJ, Monés J, Nogoceke E, Peto T, Pool FM, Rodríguez E, Ueffing M, Ulrich Bartz-Schmidt KU, van Leeuwen EM, Verzijden T, Zumbansen M, Acar N, Anastosopoulos E, Azuara-Blanco A, Bergen A, Bertelsen G, Binquet C, Bird A, Brétillon L, Bron A, Buitendijk G, Cachulo ML, Chakravarthy U, Chan M, Chang P, Colijn J, Cougnard-Grégoire A, Creuzot-Garcher C, Cumberland P, Cunha-Vaz J, Daien V, Deak G, Delcourt C, Delyfer MN, den Hollander A, Dietzel M, Erke MG, Fauser S, Finger R, Fletcher A, Foster P, Founti P, Göbel A, Gorgels T, Grauslund J, Grus F, Hammond C, Helmer C, Hense HW, Hermann M, Hoehn R, Hogg R, Holz F, Hoyng C, Jansonius N, Janssen S, Khawaja A, Klaver C, Korobelnik JF, Lamparter J, Le Goff M, Leal S, Lechanteur Y, Lehtimäki T, Lotery A, Leung I, Mauschitz M, Merle B, Meyer Zu Westrup V, Midena E, Miotto S, Mirshahi A, Mohan-Saïd S, Mueller M, Muldrew A, Nunes S, Oexle K, Peto T, Piermarocchi S, Prokofyeva E, Rahi J, Raitakari O, Ribeiro L, Rougier MB, Sahel J, Salonikiou A, Sanchez C, Schmitz-Valckenberg S, Schweitzer C, Segato T, Shehata J, Silva R, Silvestri G, Simader C, Souied E, Springelkamp H, Tapp R, Topouzis F, Verhoeven V, Von Hanno T, Vujosevic S, Williams K, Wolfram C, Yip J, Zerbib J, Zwiener I.

Author information

1
Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands.
2
Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium; Federal Agency for Medicines and Health Products, Brussels, Belgium.
3
Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.
4
Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal; Department of Ophthalmology, Coimbra Hospital and University Center (CHUC), Coimbra, Portugal; Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.
5
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
6
University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France.
7
Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
8
Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
9
Department of Ophthalmology, University Hospital, Eye and Nutrition Research Group, Dijon, France.
10
Department of Ophthalmology, Aristotle University of Thessaloniki AHEPA Hospital, Thessaloniki, Greece.
11
Department of Ophthalmology, University of Padova, Padova, Italy.
12
Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Institute of Neurosciences (NIN), Institute of the Royal Netherlands Academy of Arts and Sciences (KNAW), Department of Ophthalmology, AMC, Amsterdam and LUMC, Leiden, Netherlands.
13
Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands.
14
UiT The Arctic University of Norway/University Hospital of North Norway, Tromsø, Norway.
15
Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
16
NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Integrative Epidemiology, UCL Institute of Ophthalmology, London, United Kingdom.
17
University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France; CHU de Bordeaux, Service d'Ophtalmologie, Bordeaux, France.
18
Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, Netherlands. Electronic address: c.c.w.klaver@erasmusmc.nl.

Abstract

PURPOSE:

Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future.

DESIGN:

Meta-analysis of prevalence data.

PARTICIPANTS:

A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe.

METHODS:

AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV).

MAIN OUTCOME MEASURES:

Prevalence of early and late AMD, BCVA, and number of AMD cases.

RESULTS:

Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%-5.0%) in those aged 55-59 years to 17.6% (95% CI 13.6%-21.5%) in those aged ≥85 years; for late AMD these figures were 0.1% (95% CI 0.04%-0.3%) and 9.8% (95% CI 6.3%-13.3%), respectively. We observed a decreasing prevalence of late AMD after 2006, which became most prominent after age 70. Prevalences were similar for gender across all age groups except for late AMD in the oldest age category, and a trend was found showing a higher prevalence of CNV in Northern Europe. After 2006, fewer eyes and fewer ≥80-year-old subjects with CNV were visually impaired (P = 0.016). Projections of AMD showed an almost doubling of affected persons despite a decreasing prevalence. By 2040, the number of individuals in Europe with early AMD will range between 14.9 and 21.5 million, and for late AMD between 3.9 and 4.8 million.

CONCLUSION:

We observed a decreasing prevalence of AMD and an improvement in visual acuity in CNV occuring over the past 2 decades in Europe. Healthier lifestyles and implementation of anti-vascular endothelial growth factor treatment are the most likely explanations. Nevertheless, the numbers of affected subjects will increase considerably in the next 2 decades. AMD continues to remain a significant public health problem among Europeans.

PMID:
28712657
PMCID:
PMC5755466
DOI:
10.1016/j.ophtha.2017.05.035
[Indexed for MEDLINE]
Free PMC Article

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