gms | German Medical Science

Purpose: Geographic atrophy (GA), an advanced form of age-related macular degeneration, is one of the leading causes of visual impairment. Despite its impact, epidemiological data on GA are scarce. As these data are needed e.g. for healthcare planning, we estimate the number of GA patients in Germany.

Method: Meta-analyses of age-specific prevalence and mean prevalence of GA were identified through manual literature searches in MEDLINE. Prevalence estimates were applied to the German social health insured (SHI) patient population based on current data from KM6 statistics. Additionally, literature-based information on the ratio of prevalence estimates between GA and neovascular AMD (nAMD) was applied to estimates for patient numbers in nAMD based on German claims data to estimate the number of SHI patients with GA. In a final step, an adjusted estimate of the overall GA population based on DESTATIS information for the German population in 2021 was undertaken.

Result: Four relevant meta-analyses ([a] Rudnicka et al., 2012; [b] Rudnicka et al., 2015; [c] Owen et al., 2012; [d] Li et al., 2019) reporting the age-specific prevalence of GA were identified. Applying the age-specific prevalence estimates to the KM6 statistic for German SHI numbers from 2021 resulted in an estimated average number of 440,557 SHI patients with GA (Min: 300,337; Max: 627,394). Three of the meta-analyses [b-d] also reported a mean prevalence rate across all reported age groups. Inclusion of these overall prevalence estimates as an additional information source resulted in an estimated average of 400,689 SHI patients in Germany (Min: 275,342; Max: 573,234). Based on an alternative approach, ratios of GA:nAMD (0.714 to 1.083 [a-d]) known from the literature were applied to a recent claims-data-based estimate of German nAMD patients in the SHI (378,514–379,677 [IQWiG assessment Faricimab]) to determine an average number of 340,725 GA patients in the SHI (Min: 270,259; Max: 411,190). Averaging both approaches yielded a final number of 382,506 SHI patients with GA (Min: 272,801; Max: 492,212). Applying respective calculations to the overall German population resulted in an estimated GA patient number of 424,131 (Min: 303,135; Max: 545,127) in Germany.

Conclusion: Various approaches were used to estimate the number of GA patients in Germany, all of which resulted in numbers of a similar order of magnitude. It is assumed that approximately 300,000–550,000 people in Germany suffer from this burdensome disease.