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Global issues
Global prevalence of visual impairment associated with myopic macular degeneration and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling
  1. Timothy R Fricke1,
  2. Monica Jong1,2,
  3. Kovin S Naidoo1,2,3,
  4. Padmaja Sankaridurg1,2,
  5. Thomas J Naduvilath1,
  6. Suit May Ho1,
  7. Tien Yin Wong4,
  8. Serge Resnikoff1,2
  1. 1 Brien Holden Vision Institute, Sydney, Australia
  2. 2 School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
  3. 3 African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
  4. 4 Singapore Eye Research Institute, Singapore National Eye Center, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
  1. Correspondence to Professor Kovin S Naidoo, Brien Holden Vision Institute, University of New South Wales, Kensington, NSW 2052, Australia; k.naidoo{at}brienholdenvision.org

Abstract

Purpose We used systematic review and meta-analysis to identify and assimilate evidence quantifying blindness and visual impairment (VI) associated with myopic macular degeneration (MMD), then derived models to predict global patterns. The models were used to estimate the global prevalence of blindness and VI associated with MMD from 2000 to 2050.

Methods The systematic review identified 17 papers with prevalence data for MMD VI fitting our inclusion criteria. Data from six papers with age-specific data were scaled to relative age-dependent risk and meta-analysed at VI and blindness levels. We analysed variance in all MMD VI and blindness data as a proportion of high myopia against variables from the place and year of data collection, with a model based on health expenditure providing the best correlation. We used this model to estimate the prevalence and number of people with MMD VI in each country in each decade.

Results We included data from 17 studies comprising 137 514 participants. We estimated 10.0 million people had VI from MMD in 2015 (prevalence 0.13%, 95% CI 5.5 to 23.7 million, 0.07% to 0.34%), 3.3 million of whom were blind (0.04%, 1.8 to 7.8 million, 0.03% to 0.10%). We estimate that by 2050, without changing current interventions, VI from MMD will grow to 55.7 million people (0.57%, 29.0 to 119.7 million, 0.33% to 1.11%), 18.5 million of whom will be blind (0.19%, 9.6 to 39.7 million, 0.11% to 0.37%).

Conclusion The burden of MMD blindness and VI will rise significantly without efforts to reduce the development and progression of myopia and improve the management of MMD.

  • myopia
  • macular degeneration
  • prevalence
  • visual impairment
  • blindness

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bjophthalmol-2017-311266

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    Footnotes

    • Contributors TRF: guarantor for the paper and involved in all aspects of its design, conception, analysis, manuscript creation and editing. MJ: involved in manuscript creation and editing. KSN: involved in conception, project design and editing. PS: involved in analysis and editing. TN: involved in project design and data analysis. SMH: involved in data analysis and editing. TYW: involved in conception and editing. SR: involved in design, conception, analysis, manuscript creation and editing.

    • Funding This work was supported by a public health grant from the Brien Holden Vision Institute, Sydney, Australia.

    • Competing interests The authors have no relevant proprietary interests. TRF: consultant for Brien Holden Vision Institute. MJ: no financial disclosures. KSN: no financial disclosures. PS: no financial disclosures. TN: no financial disclosures. SMH: no financial disclosures. TYW: consultant and on advisory boards for Allergan, Bayer and Novartis. SR: consultant for Brien Holden Vision Institute and previously worked for Thea Pharmaceuticals (2008-2010).

    • Patient consent Not required.

    • Data sharing statement In addition to the article and the online supplementary file, the authors are willing to share country-specific and/or age-specific data generated by the model designed in this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Author note This submission has not been published anywhere previously and it is not simultaneously being considered for any other publication.