Incidence & prevalence

A recent meta-analysis found that AMD is the third most common cause of visual impairment (blindness and moderate or severe vision impairment – MSVI) after uncorrected refractive error and cataract in the global population in 2015.Globally 8·41 million people were estimated to have MSVI as a result of AMD in 2015; this figure is expected to rise to 8.8 million people by 2020. AMD accounted for 5.64% of cases of legal blindness worldwide in 2015 (1.96 million cases of legal blindness). The proportion of blindness caused by AMD was highest in regions with older populations (high-income regions), where anything from 10% to >14% of cases of blindness were attributable to AMD.

AMD is the leading cause of vision loss in people aged ≥50 years in developed countries. Global prevalence estimates (% of people with the disease in the global population) indicate that AMD affects 9% of people aged between 45–85 years worldwide. Globally, it is estimated that approximately 196 million people will have AMD by 2020, and this number is expected to increase to 288 million by 2040 as a result of population ageing.2

In Europe, it is estimated that the number of people affected by late AMD will almost double from 2.7 million in 2013 to 4.8 million in 2040.3

Estimated incidence rates of AMD (number of new cases in a population in a specified time period) vary between studies. A study estimating the incidence of late-stage AMD in American whites reported an annual incidence of 3.5 per 1000 aged ≥50 years, equivalent to 293,000 new cases per year.4Another study performed in the United Kingdom population, reported the annual incidence of late AMD as 4.1 per 1000 women and 2.6 per 1000 men.5


The prevalence of AMD is growing in many countries largely as a result of the aging demographics. In order for AMD to get the attention it deserves by government and healthcare authorities, it is important to have local figures to present the local situation. The data presented below are intended to be summary data only and are presented as a starting point for use by the countries listed. For the most part, the data has been presented by the age groups in the original papers. No attempt has been made to standardize the age groups to allow direct comparison between studies.

Prevalence Data – All AMDPrevalence Data – Late AMDIncidence Data – Late AMD

Impact on individuals

Impact on Patients

The loss of visual function associated with AMD negatively impacts patients’ quality of life, and deprives them of their independence and social interaction.6 Visual impairment associated with AMD can prevent people from carrying out a number of everyday activities including:7 reading (e.g. books, newspapers, lists, medicine labels), recognising faces, driving, using public transport, general mobility, socialising, shopping and caring for themselves/dependants.The loss of ability to perform everyday tasks can lead to loss of independence, social isolation and absence from work. As visual impairment worsens, independence and overall quality of life decline. Even mild visual impairment can have a substantial impact on vision-related quality life.8

Vision loss that occurs with AMD also has a major impact on emotional well-being, and those affected often report feelings of frustration, annoyance and fear of coping with everyday life. Studies suggest that as many as 1 in 3 patients with AMD suffer from symptoms of depression.9, 10

People with AMD are also at a greater risk of falls and secondary injuries that may occur as a result of them, such as hip fractures.11, 12, 13 Some studies have found that the risk of falls increase as visual acuity worsens, which underlines the importance of visual rehabilitation for people affected by AMD.

The ERN-EYE created a video to explain how we can support, comfort and welcome patients in a hospital environment. This video clip describes how to interact and communicate with people living with visual impairments to relax them before their appointment. Helpful tips include assisting people to their appointment, adjusting lighting as necessary and avoid moving their belongings, so as not to confuse and upset them. The full video is available to watch here


Impact on Caregivers

Caring for somebody with loss of visual function due to AMD is associated with a substantial burden on the carer. In many cases, spouses and/or other family members are called upon to provide physical and emotional support.14, 15 Caregivers of people with late AMD are at high risk of emotional distress and often face significant disruption to their own lives.16

A study by Macular Disease Foundation Australia (MDFA) that surveyed 500 caregivers of people with neovascular AMD, revealed a high rate of psychological distress among carers, with over half reporting a negative state of mind. More than half also had to make changes to other areas of their lives (e.g. participation in social activities or retirement plans) as a consequence of caring for someone with neovascular AMD. In this study, the level of dependence and presence of comorbid chronic illnesses in the care recipient were independent predictors of the caregiver experiencing psychological distress.

Cost to society 

After Uncorrected Refractive Error (URE) and Cataract, AMD is the leading cause of global visual impairment (blindness + Moderate and Severe Visual Impairment) at 4.1% (10.37 million) of the visually impaired population. AMD causes 5.64% of global blindness (1.96 million people).17

AMD is associated with a significant economic burden to patient, caregiver and society. As the proportion of people affected by AMD is forecast to increase considerably over the next few decades due to population ageing 18 it is important to quantify the economic cost of AMD in order to inform future healthcare planning. The economic cost of AMD may be categorised into direct and indirect costs:19

Direct costs

These include ophthalmological care, including physician visits and costs of therapies (e.g. vitamin supplements, intravitreal injections, imaging), etc., counselling, supportive equipment (low vision aids), transportation costs and resource utilisation associated with co-morbid conditions (e.g. depression, falls and other injuries).

Indirect costs

These include loss of productivity and absence from work for both patients and their caregivers and general cost to society reflected by the negative impact on a country’s gross domestic product (GDP).20


Data on the economic burden associated with AMD have been gathered from studies that are in the public domain. (Studies were reported to have been conducted on the cost of vision loss by Deloitte Access Economics on the following countries but these were not publicly accessible: Denmark, Japan, Sweden, Switzerland and Turkey.) Studies were only included if they were conducted subsequent to 2007, since the introduction of anti-VEGF treatments to most countries in that year has significantly impacted the costs associated with AMD treatment. It should be noted that some of the data in the tables are best estimates. Also since a variety of methodologies were used in these studies, one should be careful in making direct comparisons; the data should be viewed as an approximation of the costs associated with AMD in an individual country.

Economic Burden – AMD

Ageing populations

In spite of advances in healthcare generally and even with the advent of new therapies, growth in the absolute number of people with AMD and particularly late AMD are expected to plateau and grow over the next number of decades. Advanced age is the most significant risk factor for AMD. This coupled with the anticipated changes in population demographics over the next few decades, means the number of people affected by AMD is expected to increase considerably over the next few decades.21

A recent European study found that prevalence rates for AMD were 3.5% in people aged 55–59 years rising to 17.6% in those aged ≥85 years.22 In the same study prevalence rates for late-AMD were 0.1% and 9.8% respectively. Projections for AMD up to 2040 showed an almost doubling of affected persons despite a decreasing prevalence. By 2040, the number of individuals in Europe with early AMD is predicted to range between 14.9 and 21.5 million, and for late AMD between 3.9 and 4.8 million.

A recent global data analysis predicts that AMD will be the root cause of vision impairment in 8.8 million individuals with moderate or severe visual impairment and blindness in 2.0 million individuals globally by 2020.23


The UN 2015 World Population Prospects24 estimates that in 2015 the global population was 7.3bn. By 2020 it predicts this will rise to 7.8bn and 9.7bn by 2050. These predictions represent a 33% increase in the global population between 2015 and 2050. The estimates also include predictions for different age groups. In 2015 there were 901 million people over the age of 60, some 12% of the global population. By 2050 the number of people over the age of 60 is predicted to increase to 2.1 billion – 22% of the population. Even greater relative increases in the numbers of people aged 80 or more is expected – 125 million in 2015 increasing more than threefold by 2050 to 434 million. Based upon these population growth figures, the Vision Loss Expert Group (VLEG) expect the global number of blind and MSVI persons to almost triple from 253 million today to 703 million in 2050.25

Courtesy: Novartis International AG

Role of early diagnosis

AMD is a painless condition and people with the early and intermediate stages of the disease do not usually experience any symptoms. It is essential therefore that regular eye examinations are performed in order to detect the early signs of AMD and ensure patients receive appropriate treatment.

The American Academy of Ophthalmology (AAO) recommends that everyone gets a baseline eye examination at age 40, the time when early signs of disease or changes in vision may occur. A baseline eye exam at 40 acts as a reminder to adults as they age to be aware of their eye health. It can help identify signs of eye disease at an early stage when many treatments can have the greatest impact on preserving vision. Follow-up eye examinations would be dependent upon overall health and results of the baseline examination. People 65 or older should have their eyes checked every year or two. (

While the introduction of population-based screening programmes such as that recommended by AAO would increase the number of patients diagnosed with AMD and other eye diseases, many of which may also be painless and otherwise asymptomatic in their early stages (e.g. glaucoma), implementation of such a screening program would inevitably be associated with increased health care costs.

A study in Japan26 assessed the clinical and cost effectiveness of screening for AMD once every 5 years beginning at the age of 50. The results showed screening to be clinically effective, showing a decrease of 41 % in the number of blind patients. However, the screening intervention was found to be not cost-effective as it exceeded the 3-times GDP per capita per quality adjusted life year (QALY) gained.

A study in Ireland27 looked at the cost effectiveness of a hypothetical program of public education campaign and eye screening for people over 70 years. The intervention would be for screening for all causes of vision loss not just AMD. From a societal perspective the intervention would be deemed cost-effective.

Courtesy: Novartis International AG

Impact of new therapies

In 2006, clinical trials demonstrated that ocular injections of anti–vascular endothelial growth factor (anti-VEGF) can improve vision and/or prevent additional vision loss in patients with neovascular AMD with far greater efficacy than that achieved with existing therapies.28, 29, 30 A follow up study in the US31 looked at people with AMD who had regular treatment with anti-VEGF drugs. After five years, 50% of them had 20/40 vision or better, 20 percent had 20/200 vision or worse, and the rest were in-between. The previous ‘best’ treatment was photodynamic therapy (PDT) – just one year after diagnosis and treatment with PDT, typically less than 15% of patients retained 20/40 vision, and up to 40 percent declined to 20/200 vision. Without any treatment, less than 10 percent of patients retain 20/40 vision at one year, and up to 75 percent of untreated patients decline to 20/200 vision. Anti-VEGF treatment has truly revolutionised the treatment of neovascular AMD and given hope to those that suffer from this disease.

These results are further support by a recent European study where the prevalence of neovascualr AMD has been found to reduce following introduction of anti-VEGF treatments in Europe.32
Another study33 simulated the potential impact of 5 different treatment scenarios in the United States from 2010 to 2050. They projected the number of cases of early AMD to increase from 9.1 million in 2010 to 17.8 million in 2050. They projected 5 treatment scenarios, the most effective being vitamin prophylaxis followed by focal laser treatment for extra and juxtafoveal CNV and anti–vascular endothelial growth factor treatment. These researchers projected the number of cases of visual impairment and blindness due to AMD in the United States to increase from 620,000 in 2010 to 1.6 million in 2050 without treatment and to be 34.5% lower with the most effective treatment.

A phase 1 study34 of an intravitreal gene therapy conducted in the US indicated the efficacy of a single treatment dose to treat wet AMD, without the need for subsequent “rescue injections” to avoid progressive vision loss. Regulatory approval of ADVM-022 is in the pipeline to make this novel gene therapy available to patients with wet AMD. Watch this video clip to hear Szilard Kiss, MD discuss the outcomes of the OPTIC trial.


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