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. 2022 Dec 1;140(12):1202-1208.
doi: 10.1001/jamaophthalmol.2022.4401.

Prevalence of Age-Related Macular Degeneration in the US in 2019

David B Rein  1 , John S Wittenborn  1 , Zeb Burke-Conte  2 , Rohit Gulia  2 , Toshana Robalik  2 , Joshua R Ehrlich  3   4 , Elizabeth A Lundeen  5 , Abraham D Flaxman  2
Affiliations

Prevalence of Age-Related Macular Degeneration in the US in 2019

David B Rein et al. JAMA Ophthalmol. .

Abstract

Importance: Age-related macular degeneration (AMD) is a leading cause of vision loss and blindness. AMD prevalence has not been estimated for the US in over a decade and early-stage AMD prevalence estimates are scarce and inconsistently measured.

Objective: To produce estimates of early- and late-stage AMD prevalence overall and by age, gender, race and ethnicity, county, and state.

Design, setting, and participants: The study team conducted a bayesian meta-regression analysis of relevant data sources containing information on the prevalence of AMD among different population groups in the US.

Data sources: We included data from the American Community Survey (2019), the National Health and Nutrition Examination Survey (2005-2008), US Centers for Medicare & Medicaid Services claims for fee-for-service beneficiaries (2018), and population-based studies (2004-2016).

Study selection: We included all relevant data from the US Centers for Disease Control and Prevention's Vision and Eye Health Surveillance System.

Data extraction and synthesis: The prevalence of early- and late-stage AMD was estimated and stratified when possible by factors including county, age group, gender, and race and ethnicity. Data analysis occurred from June 2021 to April 2022.

Main outcomes or measures: The prevalence of early- (defined as retinal pigment epithelium abnormalities or the presence of drusen 125 or more microns in diameter in either eye) and late-stage (defined as choroidal neovascularization and/or geographic atrophy in either eye) manifestations of AMD.

Results: This study used data from nationally representative and local population-based studies that represent the populations in which they were conducted. For 2019, we estimated that there were 18.34 million people 40 years and older (95% uncertainty interval [UI], 15.30-22.03) living with early-stage AMD, corresponding to a crude prevalence rate of 11.64% (95% UI, 9.71-13.98). We estimated there were 1.49 million people 40 years and older (95% UI, 0.97-2.15) living with late-stage AMD, corresponding to a crude prevalence rate of 0.94% (95% UI, 0.62-1.36). Prevalence rates of early- and late-stage AMD varied by demographic characteristics and geography.

Conclusions and relevance: We estimated a higher prevalence of early-stage AMD and a similar prevalence of late-stage AMD as compared with earlier studies. State-level and county-level AMD estimates may help guide public health practice.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Rein reported grants from the US Centers for Disease Control and Prevention’s Vision Health Initiative Cooperative Agreement (U01DP006444) during the conduct of the study. Dr Burke-Conte reported grants from NORC at the University of Chicago during the conduct of the study. Dr Ehrlich reported personal fees from MetLife outside the submitted work. Dr Flaxman reported grants from NORC during the conduct of the study; assistance for analysis and interpretation of licensed data previously produced by Institute for Health Metrics and Evaluation from Janssen, SwissRe, and Sanofi; and advising fees from Agathos outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Crude Prevalence Rate of Early-Stage Age-Related Macular Degeneration (AMD) by Age for All Racial and Ethnic Groups in 2019
Figure 2.
Figure 2.. Age-, Gender-, and Race and Ethnicity–Standardized Early-Stage Age-Related Macular Degeneration Prevalence Rate by County in 2019
Figure 3.
Figure 3.. Crude Prevalence Rate of Late-Stage Age-Related Macular Degeneration (AMD) by Age for All Racial and Ethnic Groups in 2019
Figure 4.
Figure 4.. Age-, Gender-, and Race and Ethnicity–Standardized Late-Stage Age-Related Macular Degeneration Prevalence Rate by County in 2019
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