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VI. International Symposium on AMD – Age-Related Macular Degeneration – Emerging Concepts – Exploring known and Identifying new Pathways

11. - 12.09.2015, Baden-Baden

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Changing prevalence of AMD degeneration in Europe

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  • Johanna M. Colijn - Rotterdam
  • G.H.S. Buitendijk - Rotterdam
  • J.R. Vingerling - Rotterdam
  • A. Hofman - Rotterdam
  • C.C.W. Klaver - Rotterdam

VI. International Symposium on AMD – Age-Related Macular Degeneration – Emerging Concepts – Exploring known and Identifying new Pathways. Baden-Baden, 11.-12.09.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15amd01

doi: 10.3205/15amd01, urn:nbn:de:0183-15amd015

Published: October 1, 2015

© 2015 Colijn et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. Anti-angiogenic therapy has improved the visual outcome of neovascular AMD, but whether the burden of AMD as a whole changed is unclear. We estimated the prevalence of early and late AMD in the large European Eye Epidemiology (E3) consortium, which includes studies all over Europe that have been executed during the past 20 years.

Methods: Data collection was performed in the population-based prospective cohorts of E3 in the time period 1990 to 2012. This included 14 studies from Estonia, France, Germany, Great Britain, Greece, Italy, the Netherlands, Norway, Spain and Portugal. Participants of 40 years and older underwent ophthalmic examination including best-corrected visual acuity and fundus photography (n=41,398). The Rotterdam Classification was used to grade AMD. A meta-analysis for grouped data was used to calculate the prevalence of AMD in Europe. The prevalence of early and late AMD was stratified for age, gender and geographical area, and the time period during which studies took place.

Results: The prevalence of late AMD was lower in the time period 2006-2012 compared to 1990-2006: 6.4% (SD 3.2%) during 2006-2012 versus 13.6% (SD 4.2%, P 0.018) during 1990-2006 in persons aged 85 years and older. This decrease was less apparent for early AMD (15.2% (SD 5.9%) versus 22.9% (SD 6.0%; P 0.19) during these time periods). Prevalences showed no statistical differences between men and women, nor between the various geographic locations. The proportion of eyes with low vision or blindness caused by choroidal neovascularization decreased by 11% after 2006 compared to the time period before 2006 (32% versus 21%, P 0.051).

Conclusion: The prevalence of any late AMD and the morbidity of neovascular AMD have declined in Europe during the past 20 years. A possible explanation is the increasing implementation of beneficial lifestyle factors such as a diet rich in vegetables and fish, intake of AREDS supplements, and cessation of smoking. Findings of epidemiologic and intervention studies appear to reach the general public in Europe.