gms | German Medical Science

Purpose: As epidemiological data on age-related macular degeneration (AMD) is scarce, we used statutory health insurance (SHI) data which utilized ICD-10 German Modification (GM) diagnosis codes newly introduced in 2020 to estimate the prevalence of non-neovascular and neovascular AMD in Germany.

Method: Patients with AMD were identified from a German SHI database (AOK PLUS) comprising insured members of all ages from Saxony and Thuringia based on data from at least two outpatient ophthalmologic or one inpatient diagnosis code (ICD-10 H35.3) for each of the years 2012 to 2021. Patients without continuous observation in a calendar year were excluded. Prevalence was assessed on Dec 31^st of each year determined by number of prevalent cases divided by the total number of AOK PLUS insured persons. For 2020 and 2021, the type of AMD was assessed by ICD-10 subcodes specific for all stages of non-neovascular AMD (H35.31) and neovascular AMD (H35.30), respectively. Double assignment was allowed if both types were documented in a given year. For 2012 to 2019, prevalence was estimated based on the proportion of non-neovascular or neovascular AMD within AMD of any type, assuming that the ratios observed in 2020 and 2021 apply equally in preceding years. When conducting a Germany-wide bottom up calculation of patient numbers, the estimates were adjusted for age and sex distribution within the SHI population and the overall population in Germany.

Result: Between 2012 to 2021, the prevalence of non-neovascular AMD observed in the AOK PLUS population remained relatively stable, ranging from 0.96% (minimum in 2021) to 1.31% (maximum in 2014), about twice that of neovascular AMD (min-max: 0.53%–0.72%). After age/sex adjustment to the SHI population and the overall population in Germany, the respective rates slightly decreased (non-neovascular AMD for SHI: 0.80%–0.90%; neovascular AMD for SHI: 0.43%–0.49%; non-neovascular AMD for Germany: 0.72%–0.87%; neovascular AMD for Germany: 0.39%–0.47%).

Conclusion: The number of diagnosed cases with AMD in Germany has increased only slightly over the past decade. For the first time, patient counts with non-neovascular and neovascular AMD have been approximated for Germany based on a representative, large sample in the years 2020 and 2021. The true prevalence of non-neovascular AMD is likely underestimated in insurance claims databases as no treatment is yet available for these patients.