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Geographic distributions of age-related macular degeneration incidence: a systematic review and meta-analysis
  1. Miao Zhou1,
  2. Pei-Chen Duan1,
  3. Jing-Hong Liang2,
  4. Xiao-Feng Zhang3,
  5. Chen-Wei Pan1
  1. 1 School of Public Health, Medical College of Soochow University, Suzhou, China
  2. 2 School of Public Health, Sun Yat-Sen University, Guangzhou, China
  3. 3 Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, China
  1. Correspondence to Chen-Wei Pan, School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou 215123, China; pcwonly{at} and Xiao-Feng Zhang, Department of Ophthalmology, First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215000, China; zhangxiaofeng{at}


Purpose We performed a systematic review and meta-analysis to summarise the geographic distribution of age-related macular degeneration (AMD) incidence.

Methods Databases including PubMed, Embase and Web of Science were searched for publications of early and late AMD before September 2019. Studies were included if they applied a standardised photographic assessment and classification system. The proportion of participants with AMD in each eligible study was combined to obtain a pooled incidence from all studies using a random effects model. We also assessed sources of potential heterogeneity in the incidence of AMD using meta-regression analyses for both late and early AMD.

Results Twenty-four population-based studies (70 123 individuals aged 55 years or older) were included in the meta-analysis. The pooled global annual incidences of early and late AMD were 1.59% (95% CI 1.12% to 2.10%) and 0.19% (95% CI: 0.13% to 0.28%), respectively. Individuals of European descent had the highest annual incidence of both early (2.73%, 95% CI 1.63% to 4.57%) and late (0.36%, 95% CI 0.17% to 0.75%) AMD than other ethnic groups. Average age (p=0.001) at baseline, ethnicity (p=0.001), region (p=0.043) and gender (p=0.011) were predictors for incident late AMD, while only average age (p=0.01) at baseline and ethnicity (p=0.025) was associated with incidence of early AMD.

Conclusions This meta-analysis offers an up-to-date overview of AMD globally, which may provide scientific guidance for the design and implementation of public health strategies such as screening programmes for AMD in both specific geographic locations and ethnic groups, as well as worldwide.

  • Epidemiology

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  • MZ and P-CD contributed equally.

  • Contributors XFZ and CWP contributed substantially to the conception and design of this paper. MZ and PCD conducted the literature searches and extracted the data from published papers. MZ, PCD and JHL drafted the paper and carried out the statistical analysis.

  • Funding This study was supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).

  • Competing interests None declared.

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

  • Data availability statement Data are available upon reasonable request.

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