Prevalence of Age-Related Macular Degeneration in Europe
Authors: Johanna M. Colijn, Gabriëlle H.S. Buitendijk, Elena Prokofyeva, Dalila Alves, Maria L. Cachulo, Anthony P. Khawaja, Audrey Cougnard-Gregoire, Bénédicte M.J. Merle, Christina Korb, Maja G. Erke, Alain Bron, Eleftherios Anastasopoulos, Magda A. Meester-Smoor, Tatiana Segato, Stefano Piermarocchi, Paulus T.V.M. de Jong, Johannes R. Vingerling, Fotis Topouzis, Catherine Creuzot-Garcher, Geir Bertelsen, Norbert Pfeiffer, Astrid E. Fletcher, Paul J. Foster, Rufino Silva, Jean-François Korobelnik, Cécile Delcourt, Caroline C.W. Klaver, Soufiane Ajana, Blanca Arango-Gonzalez, Verena Arndt, Vaibhav Bhatia, Shomi S. Bhattacharya, Marc Biarnés, Anna Borrell, Sebastian Bühren, Sofia M. Calado, Johanna M. Colijn, Audrey Cougnard-Grégoire, Sascha Dammeier, Eiko K. de Jong, Berta De la Cerda, Cécile Delcourt, Anneke I. den Hollander, Francisco J. Diaz-Corrales, Sigrid Diether, Eszter Emri, Tanja Endermann, Lucia L. Ferraro, Míriam Garcia, Thomas J. Heesterbeek, Sabina Honisch, Carel B. Hoyng, Eveline Kersten, Ellen Kilger, Caroline C.W. Klaver, Hanno Langen, Imre Lengyel, Phil Luthert, Cyrille Maugeais, Magda Meester-Smoor, Bénédicte M.J. Merle, Jordi Monés, Everson Nogoceke, Tunde Peto, Frances M. Pool, Eduardo Rodríguez, Marius Ueffing, Karl U. Ulrich Bartz-Schmidt, Elisabeth M. van Leeuwen, Timo Verzijden, Markus Zumbansen, Niyazi Acar, Eleftherios Anastosopoulos, Augusto Azuara-Blanco, Arthur Bergen, Geir Bertelsen, Christine Binquet, Alan Bird, Lionel Brétillon, Alain Bron, Gabrielle Buitendijk, Maria Luz Cachulo, Usha Chakravarthy, Michelle Chan, Petrus Chang, Johanna Colijn, Audrey Cougnard-Grégoire, Catherine Creuzot-Garcher, Philippa Cumberland, José Cunha-Vaz, Vincent Daien, Gabor Deak, Cécile Delcourt, Marie-Noëlle Delyfer, Anneke den Hollander, Martha Dietzel, Maja Gran Erke, Sascha Fauser, Robert Finger, Astrid Fletcher, Paul Foster, Panayiota Founti, Arno Göbel, Theo Gorgels, Jakob Grauslund, Franz Grus, Christopher Hammond, Catherine Helmer, Hans-Werner Hense, Manuel Hermann, René Hoehn, Ruth Hogg, Frank Holz, Carel Hoyng, Nomdo Jansonius, Sarah Janssen, Anthony Khawaja, Caroline Klaver, Jean-François Korobelnik, Julia Lamparter, Mélanie Le Goff, Sergio Leal, Yara Lechanteur, Terho Lehtimäki, Andrew Lotery, Irene Leung, Matthias Mauschitz, Bénédicte Merle, Verena Meyer zu Westrup, Edoardo Midena, Stefania Miotto, Alireza Mirshahi, Sadek Mohan-Saïd, Michael Mueller, Alyson Muldrew, Sandrina Nunes, Konrad Oexle, Tunde Peto, Stefano Piermarocchi, Elena Prokofyeva, Jugnoo Rahi, Olli Raitakari, Luisa Ribeiro, Marie-Bénédicte Rougier, José Sahel, Aggeliki Salonikiou, Clarisa Sanchez, Steffen Schmitz-Valckenberg, Cédric Schweitzer, Tatiana Segato, Jasmin Shehata, Rufino Silva, Giuliana Silvestri, Christian Simader, Eric Souied, Henriet Springelkamp, Robyn Tapp, Fotis Topouzis, Virginie Verhoeven, Therese Von Hanno, Stela Vujosevic, Katie Williams, Christian Wolfram, Jennifer Yip, Jennyfer Zerbib, Isabella Zwiener
Journal: Ophthalmology (2017)

PurposeAge-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.DesignMeta-analysis of prevalence data.ParticipantsA total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe.MethodsAMD 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 MeasuresPrevalence of early and late AMD, BCVA, and number of AMD cases.ResultsPrevalence 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.ConclusionWe 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.