Dataset Information

The national and subnational prevalence and burden of age-related macular degeneration in China.

ABSTRACT: Age-related macular degeneration (AMD) is the third most common cause of blindness, and the fourth leading cause of visual impairment worldwide, but little is known about the burden of this disease in the most populous country-China. This study provides the first comprehensive estimates of the prevalence and burden of AMD in China from 1990 to 2015, with projections till 2050.In this study, a systematic review and meta-analysis was conducted to estimate the prevalence of AMD in China. China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase and Medline were searched before September 2016. Multilevel mixed-effect meta-regression was performed to define the prevalence rates of AMD and its subtypes. UN population data were used to estimate and project the number of people affected from 1990 to 2050. Based on different demographic and geographic features, the national burden of AMD in 2000 and 2010 was distributed to different regions in China.Our search returned 2016 citations, of which 25 met the inclusion criteria. The prevalence of any AMD ranged from 2.44% (95% CI?=?1.85-3.22) in people aged 45-49 years to 18.98% (95% CI?=?15.05-23.66) in people aged 85-89 years. Prevalence of early AMD ranged from 1.79% (95% CI?=?1.05-3.02) to 10.05% (95% CI?=?6.17-15.97), and, in the case of late AMD, from 0.38% (95% CI?=?0.16-0.97) to 3.88% (95% CI?=?1.68-9.13). In late AMD, the prevalence of geographic atrophy (GA) was 0.15% (95% CI?=?0.05-0.47) in people aged 45-49 years and 1.09% (95% CI?=?0.35-3.36) in those aged 85-89 years, and the prevalence of neovascular AMD (NVAMD) ranged between 0.24% (95% CI?=?0.11-0.50) and 2.79% (95% CI?=?1.33-5.77). The number of people with any AMD was 12.01 million (95% CI?=?9.29-15.46) in 1990 and 26.65 million (95% CI?=?20.62-34.27) in 2015. Within the same period, the number of people with early AMD increased from 9.44 million (95% CI?=?7.74-11.15) to 20.91 million (95% CI?=?17.16-24.68), and those with late AMD rose from 2.58 million (95% CI?=?1.56-4.30) to 5.74 million (95% CI?=?3.46-9.59). In late AMD, the number of people living with GA ranged from 0.87 million (95% CI?=?0.40-1.83) in 1990 to 1.93 million (95% CI?=?0.89-4.08) in 2015, and NVAMD from 1.71 million (95% CI?=?1.16-2.47) to 3.81 million (95% CI?=?2.57-5.51). The projected number of people with any AMD in 2020 is 31.23 million (95% CI?=?24.18-40.14), increasing to 55.19 million (95% CI?=?43.04-70.30) in 2050. Between different regions, the South Central owed the most AMD cases (5.50 million in 2000 and 7.52 million in 2010), whereas the North-West China the least (0.66 million in 2000 and 0.95 million in 2010).The estimates in this study suggest a substantial burden of AMD in China, with the ageing process in Chinese society, this burden will be increasing in the foreseen future. Primary and secondary prevention and treatment and effective government response are urgently needed. Improved epidemiological studies are also required to better develop eye-care strategies and health services.

SUBMITTER: Song P

PROVIDER: S-EPMC5735777 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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The national and subnational prevalence and burden of age-related macular degeneration in China.

Song Peige P Du Yuhang Y Chan Kit Yee KY Theodoratou Evropi E Rudan Igor I

Journal of global health 20171201 2

<h4>Background</h4>Age-related macular degeneration (AMD) is the third most common cause of blindness, and the fourth leading cause of visual impairment worldwide, but little is known about the burden of this disease in the most populous country-China. This study provides the first comprehensive estimates of the prevalence and burden of AMD in China from 1990 to 2015, with projections till 2050.<h4>Methods</h4>In this study, a systematic review and meta-analysis was conducted to estimate the pre ...[more]

PMID: 29302323

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Project description:Glaucoma, the second leading cause of blindness, affects approximately 64.3 million individuals worldwide. In China, demographic ageing is in rapid progress. Yet detailed and up-to-date estimates of the scale of glaucoma are rare. We aimed to quantify and understand the prevalence and burden of glaucoma in China from 1990 to 2015, with projections until 2050.For this systematic review and meta-analysis, we searched China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase and Medline using comprehensive search strategies to identify all relevant articles that have reported the prevalence of glaucoma in the general Chinese population. We used a multilevel mixed-effect meta-regression to estimate the prevalence rates of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and a random-effects meta-analysis to pool the overall prevalence of secondary glaucoma. United Nations population data were used to estimate and project the number of people with glaucoma from 1990 to 2050. Univariable and multivariable meta-regressions were conducted to assess the association between the prevalence of POAG and PACG and relevant demographic and geographic factors. The national burden of POAG and PACG in the years 2000 and 2010 were distributed to six geographic regions accordingly.From 1990 to 2015, the prevalence of all glaucoma ranged from 2.59% (95% CI?=?1.96-3.49) to 2.58% (95% CI?=?1.94-3.47). For different subtypes of glaucoma, the overall prevalence of POAG ranged from 1.03% (95% CI?=?0.67-1.58) in 1990 to 1.02% (95% CI?=?0.67-1.57) in 2015, PACG from 1.41% (95% CI?=?1.18-1.68) to 1.40% (95% CI?=?1.17-1.68). The overall prevalence of secondary glaucoma was 0.15% (95% CI?=?0.10-0.23) during this period. The number of people with all glaucoma in China was 5.92 million (95% CI?=?4.47-7.97) in 1990, and 13.12 million (95% CI?=?9.88-17.68) in 2015. This increasing trend was also witnessed in different subtypes of glaucoma. The number of people affected by POAG increased from 2.35 million (95% CI?=?1.54-3.60) in 1990 to 5.22 million (95% CI?=?3.40-7.98) in 2015, PACG from 3.22 million (95% CI?=?2.70-3.84) to 7.14 million (95% CI?=?5.97-8.53), and secondary glaucoma from 0.34 million (95% CI?=?0.23-0.53) to 0.76 million (95% CI?=?0.51-1.17). In 2015, more than half (54.42%) of the glaucoma cases were PACG, followed by POAG (39.79%) and secondary glaucoma (5.79%). By 2050, the number of all glaucoma cases in China will be 25.16 million (95% CI?=?18.96-33.86). In the multivariable meta-regressions, the odds ratio (OR) for each decade's increase in age was 1.43 (95% CI?=?1.33-1.55) for POAG, and 1.65 (95% CI?=?1.51-1.80) for PACG; males were more likely to have POAG (OR 1.36, 95% CI?=?1.17-1.59), but less likely to have PACG (OR 0.53, 95% CI?=?0.46-0.60) compared with females. After adjustment of age and gender, people living in urban areas were more likely to have POAG compared with those in rural areas (OR 1.54, 95% CI?=?1.02-2.35). People in Northeast China were at a higher risk (OR 1.77, 95% CI?=?1.07-2.94) of having PACG than people in East China. Among the six regions, East China owed the most POAG and PACG cases, whereas Northwest China owed the least.This systematic review and meta-analysis suggests a substantial burden of glaucoma in China, with great variances among the different age groups, genders, settings and geographic regions. With the dramatic ageing trend in the next three decades, the prevalence and burden of glaucoma will continue to increase. More elaborate epidemiological studies are needed to optimise public health strategies for mitigating this important health problem.

Project description:ImportanceAge-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.ObjectiveTo produce estimates of early- and late-stage AMD prevalence overall and by age, gender, race and ethnicity, county, and state.Design, setting, and participantsThe 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 sourcesWe 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 selectionWe included all relevant data from the US Centers for Disease Control and Prevention's Vision and Eye Health Surveillance System.Data extraction and synthesisThe 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 measuresThe 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.ResultsThis 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 relevanceWe 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.

Dataset Information

The national and subnational prevalence and burden of age-related macular degeneration in China.

Publications

The national and subnational prevalence and burden of age-related macular degeneration in China.

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