Background/Aims Age-related macular degeneration (AMD) is the main cause of visual impairment and blindness in Europe. A further increase in the number of affected persons is expected and current European data are needed for healthcare resource planning.
Methods We performed a systematic review on the prevalence and incidence of AMD based on the meta-analysis of observational studies in epidemiology guideline. Meta-analysis and meta-regression on time-trends, age, countries, regions, sex and classification systems for AMD were performed. Based on Eurostat population projections, the pooled prevalence estimates were extrapolated to the year 2050.
Results Twenty-two prevalence and four incidence studies published since 1996 were included. Our pooled prevalence estimate of early or intermediate AMD and any late AMD in those 60 years and older was 25.3% (95% CI 18.0% to 34.4%) and 2.4% (95% CI 1.8% to 3.3%), respectively. A significant increase in prevalence was seen in older populations. In the meta-analysis of incidence, the pooled annual incidence of any late AMD was 1.4 per 1 000 individuals (95% CI 0.8 to 2.6). Overall, the number of EU inhabitants with any late AMD is expected to increase from 67 to 77 million until 2050. Incident late AMD is estimated to increase from 400 000 per year today to 700 000 per year in 2050.
Conclusions Approximately 67 million people in the EU are currently affected by any AMD and, due to population ageing, this number is expected to increase by 15% until 2050. Monitoring and treatment of people with advanced disease stages will require additional healthcare resources and thorough healthcare planning in the years and decades to come.
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Contributors RPF conceived and designed the study. JQL, Julie Letow (JLe, Department of Ophthalmology, University of Bonn, Germany) and Caroline Wolpers (CW, Department of Ophthalmology, University of Bonn, German) undertook the literature search, extracted data and performed quality assessment of the included studies. JQL, TW and MS performed the data analysis. JQL, TW, MS, FGH and RPF interpreted data. JQL, TW, MS and RPF wrote the first draft of the report. RPF as guarantor accepts full responsibility for the work and the conduct of the study, had access to the data and controlled the decision to publish. All authors provided critical comments and approved the final version.
Funding European Society of Retina Specialists (EURETINA) project grant, the Jackstaedt Stiftung and the Else Kroehner Fresenius.
Disclaimer None of the funders were involved in the study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the article for publication. All researchers confirm their independence from funders. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. The sponsor of the study had no role in design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript and decision to submit the manuscript for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethics committee approval or written informed consent was not required, as our review relied entirely on publicly available published data.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on request.
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