Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of population-based studies
PubMed 25104651 · doi:10.1016/S2214-109X(13)70145-1
What was done
A systematic review was conducted to identify population-based studies of age-related macular degeneration (AMD) published before May 2013. Studies were included only if they used retinal photography and standardized grading classifications (Wisconsin, International Classification, or Rotterdam systems). Hierarchical Bayesian meta-analysis estimated pooled prevalence and 95% credible intervals (CrI) mapped to ages 45-85 years across ethnicities and regions, and UN World Population Prospects were used to project global case numbers for 2020 and 2040.
What was found
Analysis of 39 studies (129,664 individuals aged 30-97 years; 12,727 cases) showed pooled prevalence mapped to ages 45-85 of 8.01% (95% CrI 3.98-15.49) for early AMD, 0.37% (0.18-0.77) for late AMD, and 8.69% (4.26-17.40) for any AMD. Europeans had higher rates of early and any AMD than Asians (early: 11.2% vs 6.8%, Bayes factor 3.9; any: 12.3% vs 7.4%, Bayes factor 4.3) and Africans (early: 11.2% vs 7.1%, Bayes factor 12.2; late: 0.5% vs 0.3%, Bayes factor 3.7; any: 12.3% vs 7.5%, Bayes factor 31.3). Europeans had a higher prevalence of geographic atrophy (1.11%, 95% CrI 0.53-2.08) compared with Africans (0.14%), Asians (0.21%), and Hispanics (0.16%). No significant gender effect was found. Projected global cases were 196 million (95% CrI 140-261) in 2020 and 288 million (95% CrI 205-399) in 2040.
Why it matters
This study provides standardized global prevalence estimates for AMD and identifies higher susceptibility in European-descent populations compared to other ancestries. The substantial projected growth in AMD cases underscores an escalating burden on global eye-care infrastructure driven by population aging.
Limits
The credible intervals around prevalence estimates are wide (e.g., 4.26% to 17.40% for any AMD), reflecting substantial inter-study heterogeneity. Projections depend on demographic models that do not account for potential shifts in risk factors or therapeutic interventions over time. Global coverage may be unevenly distributed across less-studied regions.
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- context More women have macular degeneration than men.