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Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.

Publication ,  Journal Article
Wong, WL; Su, X; Li, X; Cheung, CMG; Klein, R; Cheng, C-Y; Wong, TY
Published in: Lancet Glob Health
February 2014

BACKGROUND: Numerous population-based studies of age-related macular degeneration have been reported around the world, with the results of some studies suggesting racial or ethnic differences in disease prevalence. Integrating these resources to provide summarised data to establish worldwide prevalence and to project the number of people with age-related macular degeneration from 2020 to 2040 would be a useful guide for global strategies. METHODS: We did a systematic literature review to identify all population-based studies of age-related macular degeneration published before May, 2013. Only studies using retinal photographs and standardised grading classifications (the Wisconsin age-related maculopathy grading system, the international classification for age-related macular degeneration, or the Rotterdam staging system) were included. Hierarchical Bayesian approaches were used to estimate the pooled prevalence, the 95% credible intervals (CrI), and to examine the difference in prevalence by ethnicity (European, African, Hispanic, Asian) and region (Africa, Asia, Europe, Latin America and the Caribbean, North America, and Oceania). UN World Population Prospects were used to project the number of people affected in 2014 and 2040. Bayes factor was calculated as a measure of statistical evidence, with a score above three indicating substantial evidence. FINDINGS: Analysis of 129,664 individuals (aged 30-97 years), with 12,727 cases from 39 studies, showed the pooled prevalence (mapped to an age range of 45-85 years) of early, late, and any age-related macular degeneration to be 8.01% (95% CrI 3.98-15.49), 0.37% (0.18-0.77), and 8.69% (4.26-17.40), respectively. We found a higher prevalence of early and any age-related macular degeneration in Europeans than in Asians (early: 11.2% vs 6.8%, Bayes factor 3.9; any: 12.3% vs 7.4%, Bayes factor 4.3), and early, late, and any age-related macular degeneration to be more prevalent in Europeans than in Africans (early: 11.2% vs 7.1%, Bayes factor 12.2; late: 0.5% vs 0.3%, 3.7; any: 12.3% vs 7.5%, 31.3). There was no difference in prevalence between Asians and Africans (all Bayes factors <1). Europeans had a higher prevalence of geographic atrophy subtype (1.11%, 95% CrI 0.53-2.08) than Africans (0.14%, 0.04-0.45), Asians (0.21%, 0.04-0.87), and Hispanics (0.16%, 0.05-0.46). Between geographical regions, cases of early and any age-related macular degeneration were less prevalent in Asia than in Europe and North America (early: 6.3% vs 14.3% and 12.8% [Bayes factor 2.3 and 7.6]; any: 6.9% vs 18.3% and 14.3% [3.0 and 3.8]). No significant gender effect was noted in prevalence (Bayes factor <1.0). The projected number of people with age-related macular degeneration in 2020 is 196 million (95% CrI 140-261), increasing to 288 million in 2040 (205-399). INTERPRETATION: These estimates indicate the substantial global burden of age-related macular degeneration. Summarised data provide information for understanding the effect of the condition and provide data towards designing eye-care strategies and health services around the world. FUNDING: National Medical Research Council, Singapore.

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Published In

Lancet Glob Health

DOI

EISSN

2214-109X

Publication Date

February 2014

Volume

2

Issue

2

Start / End Page

e106 / e116

Location

England

Related Subject Headings

  • Sex Factors
  • Prevalence
  • Population Surveillance
  • Models, Statistical
  • Middle Aged
  • Male
  • Macular Degeneration
  • Humans
  • Global Health
  • Forecasting
 

Citation

APA
Chicago
ICMJE
MLA
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Wong, W. L., Su, X., Li, X., Cheung, C. M. G., Klein, R., Cheng, C.-Y., & Wong, T. Y. (2014). Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health, 2(2), e106–e116. https://doi.org/10.1016/S2214-109X(13)70145-1
Wong, Wan Ling, Xinyi Su, Xiang Li, Chui Ming G. Cheung, Ronald Klein, Ching-Yu Cheng, and Tien Yin Wong. “Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.Lancet Glob Health 2, no. 2 (February 2014): e106–16. https://doi.org/10.1016/S2214-109X(13)70145-1.
Wong WL, Su X, Li X, Cheung CMG, Klein R, Cheng C-Y, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014 Feb;2(2):e106–16.
Wong, Wan Ling, et al. “Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.Lancet Glob Health, vol. 2, no. 2, Feb. 2014, pp. e106–16. Pubmed, doi:10.1016/S2214-109X(13)70145-1.
Wong WL, Su X, Li X, Cheung CMG, Klein R, Cheng C-Y, Wong TY. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014 Feb;2(2):e106–e116.
Journal cover image

Published In

Lancet Glob Health

DOI

EISSN

2214-109X

Publication Date

February 2014

Volume

2

Issue

2

Start / End Page

e106 / e116

Location

England

Related Subject Headings

  • Sex Factors
  • Prevalence
  • Population Surveillance
  • Models, Statistical
  • Middle Aged
  • Male
  • Macular Degeneration
  • Humans
  • Global Health
  • Forecasting