How big is the burden of visual loss caused by age related macular degeneration in the United Kingdom?

Abstract

Aims: To predict the burden of blindness, partial sight, and visual impairment (binocular visual acuity 6/18 or less) due to late stage age related macular degeneration (AMD) in the ageing population of the United Kingdom. Methods: A systematic review, followed by a request for data, was used to establish a pooled prevalence of AMD and corresponding visual loss. Prevalence figures were applied to the UK population. Using UK population trends, the future burden of AMD over the coming decade was established. Results: Pooled data from six studies showed that the prevalence of visual loss caused by AMD increased exponentially from the age of 70-85 years of age, with 3.5% (95% CI 3.0 to 4.1) having visual impairment beyond the age of 75 years. The authors estimate that there are currently 214 000 (95% CI 151 000 to 310 000) with visual impairment caused by AMD (suitable for registration). This number is expected to increase to 239 000 (95% CI 168 000 to 346 000) by the year 2011. Currently there are 172 000 (95% CI 106 000 to 279 000) and 245 000 (95% CI 163 000 to 364 000) with geographical and neovascular AMD, respectively. Conclusions: Estimates of visual impairment agree with official statistics for the number registered partially sighted or blind, caused by AMD, and are well below other figures often cited. Although these estimates are associated with wide confidence intervals (CI) and a number of caveats, they represent the best available data, which can be used to guide health and social care provision for older people in the UK setting. Implications for low vision services are outlined.A ge related macular degeneration (AMD) is the most common cause of adult blind registration in many developed countries, 1 2 including the United Kingdom.3 4 AMD occurs predominantly in older people and is associated with significant impairment in quality of life and functional independence.5 AMD is largely incurable. Treatment is appropriate for few and, at best, halts progression of the disease.6 7 Geographical variations in the provision and accessibility of low vision rehabilitation services exist. 8 Growth of the older population will increase the burden of ocular morbidity and visual disability due to AMD (assuming that there will be no improvements in factors influencing the incidence or treatment of AMD). Despite the public health importance of this condition, attempts to quantify the future burden in the United Kingdom have not been made, although analysis of sequential blind registrations in the United Kingdom may indicate an increase in the number of people with visually impairing AMD.9 However, blind registers only give data on the incidence of certification, and not the incidence or prevalence of disease. 9 The extent to which registrations reflect the prevalence of visually impairing AMD in the population is controversial, with suggestions of substantial under-registration.10 11 The few population based prevalence studies of AMD in the United Kingdom have been too small to provide reliable estimates.12-14 The pur...

Perceptions of blindness related to smoking: a hospital-based cross-sectional study

“…1 AMD is the principal cause of blindness in developed countries. It is the commonest cause for blind registration in the UK, where there are approximately 214 000 (95% confidence interval (CI): 151 000-310 000) individuals with impaired vision secondary to AMD, 2 and an estimated 54 000 people with visual impairment and almost 18 000 with blindness caused by AMD related to smoking. 3 There is minimal understanding of the public's awareness about smoking as a risk factor for blindness.…”

Can genetic risk information for age-related macular degeneration influence motivation to stop smoking? A pilot study

“…In the United Kingdom, B214 000 individuals have impaired vision secondary to AMD. 1 AMD is a complex disease whose aetiology is associated with both genetic and environmental risk factors. This has led to interest in interventions that can reduce the incidence of AMD.…”

The introduction of verteporfin photodynamic therapy in the UK: PDT users group (PDTUG) surveillance programme report 1

“…2 CNV is defined by the proportions of subtypes of CNV (classic, occult) to each other and other lesion components visible on fluorescein angiography, 3 as well as its location (extrafoveal, juxtafoveal, subfoveal). 4 Recent epidemiological studies 5,6 estimate that 3.6% of the UK population aged 75 years or older are visually impaired owing to AMD. Vision loss is more likely to be severe in patients with subfoveal lesions compared to extrafoveal 7 and can lead to a profound reduction in quality of life.…”