Global AMD Burden on the Rise

The study revealed that in 2020 approximately 1.85 million people were blinded by AMD, with another 6.23 million experiencing moderate to severe vision impairment (MSVI).

The research, conducted by the Vision Loss Expert Group (VLEG) of the Global Burden of Disease (GBD) study, was based on a systematic review and meta-analysis of population-based surveys from 1980 to 2018.

The study highlighted significant regional disparities, with high-income countries bearing the largest burden of AMD-related blindness. North Africa and the Middle East emerged as the regions with the highest prevalence of both AMD-related blindness and MSVI among those aged 50 and older.

Interestingly, the research revealed a nuanced picture of AMD’s impact over time. From 2000 to 2020, there was a global decrease of 19.29% in the crude prevalence of AMD-related blindness. However, this positive trend was offset by a 10.08% increase in the prevalence of MSVI due to AMD during the same period.

The study authors said the findings underscore the complex nature of AMD as a public health challenge. While advancements in treatment, particularly for neovascular AMD (nAMD), may have contributed to the reduction in blindness rates, the overall burden of the disease continues to grow.

This increase is likely driven by factors such as population growth, ageing demographics, and improved diagnosis and reporting, the authors said.

MULTIFACETED APPROACH REQUIRED

The study emphasises the need for a multifaceted approach to addressing AMD. This includes expanding access to existing treatments, developing new therapeutic options, and enhancing rehabilitation services. The researchers stress the importance of early intervention, regular screening, and lifestyle modifications to mitigate AMD risk factors.

“The prevalence of blindness and MSVI due to AMD is higher in older age groups, and countries with a growing life expectancy should take this information into account for better health service planning,” the study authors urged.

“But considering the current barriers to accessing AMD treatment and rehabilitation services in many regions, even a minor increase in absolute numbers might put pressure on the already overloaded public health systems.”

For eye care professionals, the findings highlight the ongoing importance of AMD management in clinical practice. The increasing prevalence of MSVI due to AMD suggests that optometrists and ophthalmologists may encounter more patients requiring long-term care and support for this condition.

The research also points to the need for continued investment in AMD research and treatment development. While current therapies have shown effectiveness in managing nAMD, there remains a significant unmet need for treatments targeting the more common dry form of the disease.

ADDITIONAL SUPPORT

From a public health perspective, the study underscores the importance of integrating AMD prevention and management into broader healthcare strategies. This may involve strengthening primary care involvement, improving access to specialised eye care services, and implementing public awareness campaigns about AMD risk factors and early symptoms.

Macular Disease Foundation Australia (MDFA) CEO Dr Kathy Chapman said it highlighted the need to not be “complacent” about macular disease.

“An ageing population requires greater support outside of clinics due to diverse needs beyond medical care, including social interaction, mental health support, and assistance with daily activities, particularly when living with low vision.

“MDFA recently launched Eye Connect, Australia’s first comprehensive support service for people living with an AMD diagnosis to address this need,” Dr Chapman said.

“Studies have shown that only 56% of patients with macular disease recall receiving a clear diagnosis, including the name of their condition, with 58% of patients unable to recall receiving any lifestyle modification advice from their eye care professional. With macular disease prevalence numbers closing in on two million in Australia, we can’t be complacent about the challenges ahead of us.”

For further information about Eye Connect, visit: mdfoundation.com.au/refer-to-eyeconnect.

Reference

1. Vision Loss Expert Group of the Global Burden of Disease Study, the GBD 2019 Blindness and Vision Impairment Collaborators. Global estimates on the number of people blind or visually impaired by age-related macular degeneration: A meta-analysis from 2000 to 2020. Eye (2024). doi: 10.1038/s41433-024-03050-z.