Age and gender variations in age-related macular degeneration prevalence in populations of European ancestry: a meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of population-based studies
PubMed 22176800 · doi:10.1016/j.ophtha.2011.09.027
What was done
A systematic review and Bayesian meta-regression of population-based studies published through September 2010 (MEDLINE, EMBASE, Web of Science) evaluated the prevalence of late age-related macular degeneration (AMD), geographic atrophy (GA), and neovascular AMD (NVAMD) among populations of European ancestry. The model evaluated associations with age, gender, and study year while adjusting for study design and classification methods.
What was found
Across 25 studies comprising 57,173 subjects (1,571 late AMD, 455 GA, 464 NVAMD), late AMD prevalence increased exponentially with age (odds ratio [OR] 4.2 per decade; 95% credible interval [CrI], 3.8–4.6), with estimated late AMD prevalence of 1.4% (95% CrI, 1.0%–2.0%) at age 70, 5.6% (95% CrI, 3.9%–7.7%) at age 80, and 20% (95% CrI, 14%–27%) at age 90. Age explained 20% of cross-study variability, while study methodology explained 50%. Compared to studies using fundus imaging and international classification systems, studies using alternative classifications with imaging reported higher late AMD prevalence (OR 2.7; 95% CrI, 1.1–2.8), as did alternative classifications without imaging (OR 2.9; 95% CrI, 1.3–7.8). Women showed slightly higher risk for NVAMD specifically (OR 1.2; 95% CrI, 1.0–1.5), but no late AMD gender difference or secular time trends were found.
Why it matters
The analysis establishes benchmark, age-stratified prevalence rates of late AMD for healthcare planning in European-descended populations. It also demonstrates that half of the observed variability across historical literature stemmed from disparate diagnostic and classification methods rather than true demographic differences.
Limits
The findings apply exclusively to individuals of European descent and cannot be generalized to other ancestral groups. Substantial heterogeneity existed across included studies due to differing diagnostic criteria, and individual patient-level data were not analyzed.
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