Subscribe to RSS
DOI: 10.1055/a-2105-1064
Age-Related Macular Degeneration in an Ageing Society – Current Epidemiological Research
Article in several languages: English | deutschAuthors

Abstract
Epidemiological studies on age-related macular degeneration (AMD) provide crucial data on the frequency of early and late forms as well as associated risk factors. The increasing number of population-based cross-sectional and longitudinal cohort studies in Germany and Europe with published data is making prevalence and incidence estimators for AMD more robust, although they show mostly method-related fluctuations. This review article brings together the latest published epidemiological measures for AMD from Germany and Central as well as Western Europe. Based on this data and population figures for Germany and Europe, prevalence is projected, and future trends are forecasted. The epidemiological evidence for AMD-associated risk factors is also improving, especially through meta-analyses within large consortia with correspondingly high case numbers. This review article summarizes the latest findings and resulting recommendations for prevention approaches. Additionally, it discusses treatment options and future challenges.
Key words
age-related macular degeneration (AMD) - prevalence - incidence - risk factors - population-based studies - demographic developmentPublication History
Received: 26 April 2023
Accepted: 22 May 2023
Article published online:
04 September 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References/Literatur
- 1
Lim LS,
Mitchell P,
Seddon JM.
et al.
Age-related macular degeneration. Lancet 2012; 379: 1728-1738
Reference Ris Wihthout Link
- 2
Klein R,
Meuer SM,
Myers CE.
et al.
Harmonizing the classification of age-related macular degeneration in the three-continent
AMD consortium. Ophthalmic Epidemiol 2014; 21: 14-23
Reference Ris Wihthout Link
- 3
Buitendijk GHS,
Rochtchina E,
Myers C.
et al.
Prediction of age-related macular degeneration in the general population: The three
continent AMD consortium. Ophthalmology 2013; 120: 2644-2655
Reference Ris Wihthout Link
- 4
Korb CA,
Kottler UB,
Wolfram C.
et al.
Prevalence of age-related macular degeneration in a large European cohort: results
from the population-based Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol
2014; 252: 1403-1411
Reference Ris Wihthout Link
- 5
Lüdtke L,
Jürgens C,
Ittermann T.
et al.
Age-Related Macular Degeneration and Associated Risk Factors in the Population-Based
Study of Health in Pomerania (SHIP-Trend). Med Sci Monit 2019; 25: 6383
Reference Ris Wihthout Link
- 6
Brandl C,
Breinlich V,
Stark KJ.
et al.
Features of Age-Related Macular Degeneration in the General Adults and Their Dependency
on Age, Sex, and Smoking: Results from the German KORA Study. PLoS One 2016; 11: e0167181
Reference Ris Wihthout Link
- 7
Brandl C,
Zimmermann ME,
Gunther F.
et al.
On the impact of different approaches to classify age-related macular degeneration:
Results from the German AugUR study. Sci Rep 2018; 8: 1-10
Reference Ris Wihthout Link
- 8
Li JQ,
Welchowski T,
Schmid M.
et al.
Prevalence and incidence of age-related macular degeneration in Europe: A systematic
review and meta-analysis. Br J Ophthalmol 2020; 104: 1077-1084
Reference Ris Wihthout Link
- 9
Korb CA,
Elbaz H,
Schuster AK.
et al.
Five-year cumulative incidence and progression of age-related macular degeneration:
results from the German population-based Gutenberg Health Study (GHS). Graefes Arch
Clin Exp Ophthalmol 2022; 260: 55-64
Reference Ris Wihthout Link
- 10
Brandl C,
Günther F,
Zimmermann ME.
et al.
Incidence, progression and risk factors of age-related macular degeneration in 35–95-year-old
individuals from three jointly designed German cohort studies. BMJ Open Ophthalmol
2022; 7: e000912
Reference Ris Wihthout Link
- 11
Davis MD,
Gangnon RE,
Lee LY.
et al.
The Age-Related Eye Disease Study severity scale for age-related macular degeneration:
AREDS Report No. 17. Arch Ophthalmol 2005; 123: 1484-1498
Reference Ris Wihthout Link
- 12
Klein R,
Davis MD,
Magli YL.
et al.
The Wisconsin age-related maculopathy grading system. Ophthalmology 1991; 98: 1128-1134
Reference Ris Wihthout Link
- 13
Ferris FL,
Davis MD,
Clemons TE.
et al.
A simplified severity scale for age-related macular degeneration: AREDS Report No. 18.
Arch Ophthalmol 2005; 123: 1570-1574
Reference Ris Wihthout Link
- 14
Ferris FL3rd
Wilkinson CP,
Bird A.
et al.
Clinical classification of age-related macular degeneration. Ophthalmology 2013; 120:
844-851
Reference Ris Wihthout Link
- 15
Grassmann F,
Mengelkamp J,
Brandl C.
et al.
A Deep Learning Algorithm for Prediction of Age-Related Eye Disease Study Severity
Scale for Age-Related Macular Degeneration from Color Fundus Photography. Ophthalmology
2018; 125: 1410-1420
Reference Ris Wihthout Link
- 16
Garzone D,
Terheyden JH,
Morelle O.
et al.
Comparability of automated drusen volume measurements in age-related macular degeneration:
a MACUSTAR study report. Sci Rep 2022; 12: 21911
Reference Ris Wihthout Link
- 17
Gattoussi S,
Buitendijk GHS,
Peto T.
et al.
The European Eye Epidemiology spectral-domain optical coherence tomography classification
of macular diseases for epidemiological studies. Acta Ophthalmol 2019; 97: 364-371
Reference Ris Wihthout Link
- 18
Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE).
Rheinland-Studie. Im Internet (Stand: 16.05.2023): https://www.rheinland-studie.de/
Reference Ris Wihthout Link
- 19
German National Cohort (GNC) Consortium.
The German National Cohort: aims, study design and organization. Eur J Epidemiol 2014;
29: 371-382
Reference Ris Wihthout Link
- 20
Statistisches Bundesamt.
Vorausberechneter Bevölkerungsstand. 2022. Im Internet (Stand: 16.05.2023): https://www-genesis.destatis.de/genesis/online?operation=ergebnistabelleUmfang&levelindex=2&levelid=1681828897390&downloadname=12421-0002%23abreadcrumb
Reference Ris Wihthout Link
- 21
Gesundheitsberichterstattung des Bundes.
Bevölkerung in 1000 (Prognose) nach der 15. koordinierten Bevölkerungsvorausberechnung.
Gliederungsmerkmale: Jahre, Deutschland, Alter, Variante Bevölkerungsprognose. Im
Internet (Stand: 16.05.2023): https://www.gbe-bund.de/gbe/pkg_isgbe5.prc_menu_olap?p_uid=gast&p_aid=65519721&%20p_sprache=D&%20p_help=4&%20p_indnr=716&%20p_indsp=&%20p_ityp=H
Reference Ris Wihthout Link
- 22
Fritsche LG,
Igl W,
Bailey JNC.
et al.
A large genome-wide association study of age-related macular degeneration highlights
contributions of rare and common variants. Nat Genet 2016; 48: 134-143
Reference Ris Wihthout Link
- 23
Holliday EG,
Smith AV,
Cornes BK.
et al.
Insights into the genetic architecture of early stage age-related macular degeneration:
a genome-wide association study meta-analysis. PLoS One 2013; 8: e53830
Reference Ris Wihthout Link
- 24
Winkler TW,
Grassmann F,
Brandl C.
et al.
Genome-wide association meta-analysis for early age-related macular degeneration highlights
novel loci and insights for advanced disease. BMC Med Genomics 2020; 13: 120
Reference Ris Wihthout Link
- 25
Velilla S,
Garcia-Medina JJ,
Garcia-Layana A.
et al.
Smoking and age-related macular degeneration: review and update. J Ophthalmol 2013;
2013: 895147
Reference Ris Wihthout Link
- 26
Milton RC,
Clemons TE,
Klien R.
et al.
Risk factors for the incidence of advanced age-related macular degeneration in the
Age-Related Eye Disease Study (AREDS): AREDS report no. 19. Ophthalmology 2005; 112:
533-539.e1
Reference Ris Wihthout Link
- 27
Klein R,
Myers CE,
Buitendijk GH.
et al.
Lipids, lipid genes, and incident age-related macular degeneration: the three continent
age-related macular degeneration consortium. Am J Ophthalmol 2014; 158: 513-524.e3
Reference Ris Wihthout Link
- 28
Erke MG,
Bertelsen G,
Peto T.
et al.
Cardiovascular risk factors associated with age-related macular degeneration: the
Tromsø Study. Acta Ophthalmol 2014; 92: 662-669
Reference Ris Wihthout Link
- 29
Mauschitz MM,
Schmitz MT,
Verzijden T.
et al.
Physical Activity, Incidence, and Progression of Age-Related Macular Degeneration:
A Multicohort Study. Am J Ophthalmol 2022; 236: 99-106
Reference Ris Wihthout Link
- 30
Merle BMJ,
Cougnard-Grégoire A,
Delyfer MN.
et al.
Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration: The
EYE-RISK Consortium. Ophthalmology 2019; 126: 381-390
Reference Ris Wihthout Link
- 31
Stahl A.
Diagnostik und Therapie der altersabhängigen Makuladegeneration. Dtsch Arztebl Int
2020; 117: 513-520
Reference Ris Wihthout Link
- 32
Blitzer AL,
Ham SA,
Colby KA.
et al.
Association of Metformin Use With Age-Related Macular Degeneration: A Case-Control
Study. JAMA Ophthalmol 2021; 139: 302-309
Reference Ris Wihthout Link
- 33
Mauschitz MM,
Verzijden T,
Schuster AK.
et al.
Association of lipid-lowering drugs and antidiabetic drugs with age-related macular
degeneration: a meta-analysis in Europeans. Br J Ophthalmol 2022;
Reference Ris Wihthout Link
- 34
Romdhoniyyah DF,
Harding SP,
Cheyne CP.
et al.
Metformin, A Potential Role in Age-Related Macular Degeneration: A Systematic Review
and Meta-Analysis. Ophthalmol Ther 2021; 10: 245-260
Reference Ris Wihthout Link
- 35
Spaide RF,
Ooto S,
Curcio CA.
Subretinal drusenoid deposits AKA pseudodrusen. Surv Ophthalmol 2018; 63: 782-815
Reference Ris Wihthout Link
- 36
Ajana S,
Cougnard-Grégoire A,
Colijn JM.
et al.
Predicting Progression to Advanced Age-Related Macular Degeneration from Clinical,
Genetic, and Lifestyle Factors Using Machine Learning. Ophthalmology 2021; 128: 587-597
Reference Ris Wihthout Link
- 37
Wecker T,
Grundel B,
Reichl S.
et al.
Anti-VEGF injection frequency correlates with visual acuity outcomes in pro re nata
neovascular AMD treatment. Sci Rep 2019; 9: 3301
Reference Ris Wihthout Link
- 38
Holz FG,
Tadayoni R,
Beatty S.
et al.
Key drivers of visual acuity gains in neovascular age-related macular degeneration
in real life: findings from the AURA study. Br J Ophthalmol 2016; 100: 1623-1628
Reference Ris Wihthout Link
- 39
Eter N,
Hasanbasic Z,
Keramas G.
et al.
PERSEUS24-month analysis: a prospective non-interventional study to assess the effectiveness
of intravitreal aflibercept in routine clinical practice in Germany in patients with
neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2021;
259: 2213-2223
Reference Ris Wihthout Link
- 40
Colijn JM,
Buitendijk GHS,
Prokofyeva E.
et al.
Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future.
Ophthalmology 2017;
Reference Ris Wihthout Link
- 41
Delcourt C,
Diaz JL,
Ponton-Sanchez A.
et al.
Smoking and age-related macular degeneration. The POLA Study. Pathologies Oculaires
Liées à lʼAge. Arch Ophthalmol (Chicago, Ill 1960) 1998; 116: 1031-1035
Reference Ris Wihthout Link
- 42
Hogg RE,
Wright DM,
Quinn NB.
et al.
Prevalence and risk factors for age-related macular degeneration in a population-based
cohort study of older adults in Northern Ireland using multimodal imaging: NICOLA
Study. Br J Ophthalmol 2022;
Reference Ris Wihthout Link
- 43
Akuffo KO,
Nolan J,
Stack J.
et al.
Prevalence of age-related macular degeneration in the Republic of Ireland. Br J Ophthalmol
2015; 99: 1037-1044
Reference Ris Wihthout Link
- 44
Yip JLY,
Khawaja AP,
Chan MPY.
et al.
Area deprivation and age related macular degeneration in the EPIC-Norfolk Eye Study.
Public Health 2015; 129: 103-109
Reference Ris Wihthout Link
- 45
Wilde C,
Poostchi A,
Mehta RL.
et al.
Prevalence of age-related macular degeneration in an elderly UK Caucasian population
– The Bridlington Eye Assessment Project: a cross-sectional study. Eye 2017;
Reference Ris Wihthout Link
- 46
Augood CA,
Vingerling JR,
de Jong PT.
et al.
Prevalence of age-related maculopathy in older Europeans: the European Eye Study (EUREYE).
Arch Ophthalmol 2006; 124: 529-535
Reference Ris Wihthout Link
- 47
Klaver CC,
Assink JJ,
van Leeuwen R.
et al.
Incidence and progression rates of age-related maculopathy: the Rotterdam Study. Invest
Ophthalmol Vis Sci 2001; 42: 2237-2241
Reference Ris Wihthout Link
- 48
Delcourt C,
Lacroux A,
Carrière I.
The three-year incidence of age-related macular degeneration: the “Pathologies Oculaires
Liées à lʼAge” (POLA) prospective study. Am J Ophthalmol 2005; 140: 924-926
Reference Ris Wihthout Link
- 49
Saunier V,
Merle BMJ,
Delyfer MN.
et al.
Incidence of and Risk Factors Associated With Age-Related Macular Degeneration: Four-Year
Follow-up From the ALIENOR Study. JAMA Ophthalmol 2018; 136: 473-481
Reference Ris Wihthout Link
- 50
Buch H,
Nielsen V N,
Vinding T.
et al.
14-Year incidence, progression, and visual morbidity of age-related maculopathy: The
Copenhagen City Eye Study. Ophthalmology 2005;
Reference Ris Wihthout Link