The pattern and gender disparity in global burden of age-related macular degeneration

Purpose: To explore the trend patterns and gender disparity in global burden of age-related macular degeneration (AMD) by year, age, and socioeconomic status using disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) study 2017. Methods: DALYs and impairment data caused by AMD were extracted from GBD Study 2017. World Bank income level (WBIL) and human development index (HDI) in 2017 were cited as indicators of socioeconomic status. The Gini coefficients and the concentration indexes were calculated to unveil trends in between-country inequality. The association between gender inequality and socioeconomic levels was analyzed by Pearson correlation. Results: Total age-standardized DALYs of AMD showed a slightly descending pattern in recent years. However, gender disparity has existed since 1990 for almost three decades, with female being more heavily impacted. This pattern became more obvious with aging and varied among different WHO and WBIL regions. Meanwhile, female subjects tended to have higher vision impairments. Gini coefficients of AMD burden increased from 0.423 to 0.448, while the ones of female-to-male ratio fluctuated around 0.11 between 1990 and 2017, with concentration indexes changing from 0.024 to −0.057 and 0.046 to 0.029 respectively. Female-minus-male difference ( r = 0.1721, p = 0.0195) and female-to-male ratio ( r = 0.2072, p = 0.0048) of age-standardized DALYs rates were positively related to HDI. Conclusions: Though global AMD health care is progressing, gender imbalance in disease burden of AMD distribution barely improved. Gender sensitive health policy should be emphasized for the increasing elder population and relieving the higher AMD burden of females.

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Association of Sex with the Global Burden of Age-related Macular Degeneration

10.21203/rs.3.rs-115175/v1 ◽

2020 ◽

Author(s):

Jing Wu ◽

Jiayue Zhou ◽

Xiajing Tang ◽

Xiaoning Yu ◽

Xingchao Shentu

Keyword(s):

Socioeconomic Status ◽

Linear Regression ◽

Macular Degeneration ◽

Human Development ◽

Pearson Correlation ◽

Age Related Macular Degeneration ◽

Global Burden ◽

Regression Analyses ◽

Public Attention ◽

Age Related

Abstract Background: Age-related macular degeneration (AMD) is the third leading cause of blindness and affects approximately 196 million people. This study aims to explore the association of sex with the global burden of AMD by year, age, and socioeconomic status using disability-adjusted life-years (DALYs).Methods: Global, national sex-specific DALY numbers, crude DALY rates, and age-standardized DALY rates caused by AMD, by year and age, were extracted from the Global Burden of Disease Study 2017. The human development index (HDI) in 2017 was extracted as an indicator of national socioeconomic status from the Human Development Report 2018 (HDR 2018). Pearson correlation and linear regression analyses were conducted to investigate the association between socioeconomic status and sex inequality of AMD.Results: Differences in the sex-specific global burden of AMD have persisted since 1990 to 2017. Female individuals had higher burden than male individuals of the same age in 2017, and the differences gradually increased after 55 years and maximized at 80 years or older with 105.41 DALYs rates in female vs 81.00 DALYs rates in male. The paired Wilcoxon signed rank test indicated that female had higher age-standardized DALY rates than male had (Z = -6.520, P < 0.001) and countries with lower HDI values had higher age-standardized DALY rates among both sexes. DALY rate ratio and sex differences in age-standardized DALY rates were positively associated with HDI in both Pearson correlation analyses and linear regression analyses of AMD. (P < 0.05).Conclusions: Although global blindness and vision impairment health care is progressing, sex inequality in AMD burden remained persistent since the past few decades. These findings might raise more public attention to the gender differences in global AMD burden and the association between the sex-related global burden and socioeconomic status.

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Disparities in the Global Burden of Age-Related Macular Degeneration: An Analysis of Trends from 1990 to 2015

Current Eye Research ◽

10.1080/02713683.2019.1576907 ◽

2019 ◽

Vol 44 (6) ◽

pp. 657-663 ◽

Cited By ~ 2

Author(s):

Decai Wang ◽

Yu Jiang ◽

Miao He ◽

Jane Scheetz ◽

Wei Wang

Keyword(s):

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Global Burden ◽

Age Related

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Do age-related macular degeneration genes show association with keratoconus?

Eye and Vision ◽

10.1186/s40662-019-0164-z ◽

2019 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Ke Cao ◽

Srujana Sahebjada ◽

Andrea J. Richardson ◽

Paul N. Baird

Keyword(s):

Macular Degeneration ◽

Multiple Testing ◽

Age Related Macular Degeneration ◽

Nucleotide Polymorphisms ◽

Corneal Curvature ◽

Single Nucleotide ◽

Public And Private ◽

Age Related ◽

Potential Association ◽

And Gender

Abstract Background Keratoconus (KC) is a common corneal condition with an unknown gender predominance. Although numerous studies have investigated the genetic component of KC, no specific genes have yet been attributed to the condition. We recently reported posterior segment changes occurring in the eyes of KC patients. However, it is not clear whether these changes are part of KC pathogenesis or reflect changes in anatomical features of the eye manifested by changes at the cornea. Given retinal changes represent the main characteristics observed in age-related macular degeneration (AMD) and that pleiotropy has been demonstrated between different eye diseases, we wished to assess if known AMD associated genes were also associated with KC. Methods A total of 248 KC subjects and 366 non-KC (control) subjects were recruited from public and private clinics in Melbourne for this analysis. Nineteen single nucleotide polymorphisms (SNPs) previously associated with AMD, including rs10490924 (ARMS2/HTRA1), rs10737680 (CFH), rs13278062 (TNFRSF10A), rs1864163 (CETP), rs2230199 (C3), rs3130783 (IER3/DDR1), rs334353 (TGFBR1), rs3812111 (COL10A1), rs429608 (C2/CFB), rs4420638 (APOE), rs4698775 (CFI), rs5749482 (TIMP3), rs6795735 (ADAMTS9), rs8017304 (RAD51B), rs8135665 (SLC16A8), rs920915 (LIPC), rs943080 (VEGFA), rs9542236 (B3GALTL) and rs13081855 (COL8A1/FILIP1L), were genotyped in this cohort. Logistic regression was applied to evaluate the association between these SNPs and KC on both genders together, as well as each gender separately. Linear regression was also applied to assess the association between SNPs and corneal curvature. Bonferroni correction was applied to adjust for multiple testing. Results Genotyping data were available for 18 SNPs. The SNP, rs6795735 (ADAMTS9) was significantly associated with KC (p = 3.5 × 10− 4) when both genders were assessed, whereas rs5749482 (TIMP3) was only associated in males (p = 7.7 × 10− 4) following Bonferroni multiple correction. However, when the covariates of age and gender were included, the associations became non-significant. In addition, none of the SNPs appeared significant for corneal curvature. Conclusions Our study suggested a potential association of rs6795735 in the ADAMTS9 gene and rs5749482 in the TIMP3 gene in KC and that different associations may be gender specific. Overall, SNPs initially identified as associated with AMD following multiple correction may be further impacted by other factors such as age or gender and further studies are needed to resolve this issue.

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Socioeconomic status and visual outcome in patients with neovascular age-related macular degeneration

European Journal of Ophthalmology ◽

10.1177/1120672120920783 ◽

2020 ◽

pp. 112067212092078

Author(s):

Nadav Levinger ◽

Gala Beykin ◽

Michelle Grunin ◽

Diego Almeida ◽

Jaime Levy ◽

...

Keyword(s):

Socioeconomic Status ◽

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Degeneration ◽

Medical Information ◽

Visual Outcome ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Age Related ◽

Baseline Visual Acuity

Purpose Visual outcome in patients with neovascular age-related macular degeneration is variable. We aimed to evaluate for association between socioeconomic status visual acuity in neovascular age-related macular degeneration. Methods A retrospective single-center study of a consecutive group of neovascular age-related macular degeneration patients was performed. Socioeconomic status was determined for each patient based on the 2008 Israeli census. Medical information was extracted from medical records and included visual acuity and optical coherence tomography parameters. Associations between socioeconomic status and clinical outcomes were analyzed. Results A total of 233 patients were included in the analysis. A correlation was found between low baseline visual acuity of the first eye diagnosed with neovascular age-related macular degeneration and low socioeconomic status (r = −0.13, p = 0.049; n = 233). The difference between the visual acuity of the lowest and the highest socioeconomic status categories at baseline was approximately 3 ETDRS lines (p = 0.048). Socioeconomic status and baseline visual acuity of the second eye of the same individual with neovascular age-related macular degeneration were not correlated (r = −0.05, p = 0.95). Socioeconomic status was not associated with the number of anti-vascular endothelial growth factor injections of the first or second eye, or the visual acuity outcome of the first or second eye after 1 year of therapy (p = 0.421, p = 0.9, respectively). Central subfield thickness of the first eye at presentation as measured by spectral-domain optical coherence tomography was associated with socioeconomic status (r = −0.31 p = 0.001). Conclusion Individuals of lower socioeconomic status presented at more advanced stage of the disease when developing neovascular age-related macular degeneration in the first eye but not in the second eye. The research underscores the importance of improving referral patterns and awareness for the lowest socioeconomic status classes.

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Haplotypes of HTRA1 rs1120638, TIMP3 rs9621532, VEGFA rs833068, CFI rs10033900, ERCC6 rs3793784, and KCTD10 rs56209061 Gene Polymorphisms in Age-Related Macular Degeneration

Disease Markers ◽

10.1155/2019/9602949 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Rasa Liutkeviciene ◽

Alvita Vilkeviciute ◽

Greta Gedvilaite ◽

Kriste Kaikaryte ◽

Loresa Kriauciuniene

Keyword(s):

Macular Degeneration ◽

Protective Factor ◽

Protective Role ◽

Age Related Macular Degeneration ◽

Nucleotide Polymorphisms ◽

Exudative Amd ◽

Age Related ◽

Increased Risk ◽

And Gender ◽

The Impact

Background. To determine the impact of HTRA1 rs1120638, TIMP3 rs9621532, VEGFA rs833068, CFI rs10033900, ERCC6 rs3793784, and KCTD10 rs56209061 genotypes on the development of age-related macular degeneration (AMD) in the Lithuanian population. Methods. A total of 916 subjects were examined: 309 patients with early AMD, 301 patients with exudative AMD, and 306 healthy controls. The genotyping of HTRA1 rs11200638, TIMP3 rs9621532, VEGFA rs833068, CFI rs10033900, ERCC6 rs3793784, and KCTD10 rs56209061 was carried out using the RT-PCR method. Results. Our study showed that single-nucleotide polymorphisms rs3793784 and rs11200638 were associated with increased odds of early and exudative AMD, and the variant in KCTD10 (rs56209061) was found to be associated with decreased odds of early and exudative AMD development after adjustments for age and gender in early AMD analysis and after adjustments only for age in exudative AMD. The haplotype containing two minor alleles C-A and the G-A haplotype in rs3793784-rs11200638 were statistically significantly associated with an increased risk of exudative AMD development after adjustment for age, while the G-G haplotype showed a protective role against early and exudative AMD and the haplotype C-G in rs3793784-rs11200638 was associated with a decreased risk only of exudative AMD development. Conclusions. Our study identified two markers, rs11200638 and rs3793784, as risk factors for early and exudative AMD, and one marker, rs56209061, as a protective factor for early and exudative AMD development. The haplotypes constructed of rs3793784-rs11200638 were found to be associated with AMD development, as well.

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Age and Gender Variations in Age-related Macular Degeneration Prevalence in Populations of European Ancestry: A Meta-analysis

Ophthalmology ◽

10.1016/j.ophtha.2011.09.027 ◽

2012 ◽

Vol 119 (3) ◽

pp. 571-580 ◽

Cited By ~ 147

Author(s):

Alicja R. Rudnicka ◽

Zakariya Jarrar ◽

Richard Wormald ◽

Derek G. Cook ◽

Astrid Fletcher ◽

...

Keyword(s):

Macular Degeneration ◽

Meta Analysis ◽

Age Related Macular Degeneration ◽

European Ancestry ◽

Age And Gender ◽

Age Related ◽

And Gender ◽

Gender Variations

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Circulating salusin-beta levels in the patients with age-related macular degeneration

International Journal of Clinical and Experimental Ophthalmology ◽

10.29328/journal.ijceo.1001034 ◽

2021 ◽

Vol 5 (1) ◽

pp. 001-004

Author(s):

Turgut Burak ◽

Mercan Kadir ◽

Demir Nesrin ◽

Ilhan Nevin ◽

Çatak Onur

Keyword(s):

Macular Degeneration ◽

Study Groups ◽

Age Related Macular Degeneration ◽

Enzyme Linked Immunosorbent Assay ◽

Age Related ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

And Gender ◽

Group 1

Purpose: To evaluate the levels of salusin-beta (β-SAL) in the serum in patients with age-related macular degeneration (ARMD). Methods: Our study was designed as a controlled comparative clinical study. The β-SAL levels in serums of age and sex-matched 20 healthy volunteers as controls (Group 1), 20 patients with dry-age related macular degeneration (d-ARMD) (Group 2) and 20 patients with wet-age related macular degeneration (w-ARMD) (Group 3) were measured with the enzyme-linked immunosorbent assay (ELISA) method. Results: In our study, it was found that age and gender didn’t show a statistically significant difference among the study groups (p > 0. 05). The mean serum β-SAL levels in Group 1, Group 2 and Group 3 were 1372,17 ± 1126.69 pg/mL; 1423,71 ± 1196.84 pg/mL and 940,57 ± 1092.05 pg/mL, respectively. Although the meanβ-SAL levels in w-ARMD seem numerically lower than both the control and d-ARMD groups, this difference among the study groups was not statistically significant (p > 0.05). Conclusion: Our study suggests that β-SAL levels in the patients with ARMD and healthy controls were not different than each other. Further studies with large numbers may reveal possible relationships between β-SAL and ARMD.

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SOCIOECONOMIC STATUS AND MISSED CLINICAL APPOINTMENTS IN AGE-RELATED MACULAR DEGENERATION

Innovation in Aging ◽

10.1093/geroni/igy023.1861 ◽

2018 ◽

Vol 2 (suppl_1) ◽

pp. 500-501

Author(s):

B Dougherty ◽

S Cooley ◽

R Deffler ◽

F Davidorf

Keyword(s):

Socioeconomic Status ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Age Related

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Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310939 ◽

2017 ◽

Vol 102 (4) ◽

pp. 465-472 ◽

Cited By ~ 3

Author(s):

Aaron Y Lee ◽

Thomas Butt ◽

Emily Chew ◽

Elvira Agron ◽

Traci E Clemons ◽

...

Keyword(s):

Cost Effectiveness ◽

Macular Degeneration ◽

Real World ◽

Age Related Macular Degeneration ◽

Sensitivity Analyses ◽

Health State ◽

Supplement Use ◽

Age Related ◽

Life Years ◽

Disease Study

AimsTo evaluate the cost-effectiveness of Age-Related Eye Disease Study (AREDS) 1 & 2 supplements in patients with either bilateral intermediate age-related macular degeneration, AREDS category 3, or unilateral neovascular age-related macular degeneration AMD (nAMD), AREDS category 4.MethodsA patient-level health state transition model based on levels of visual acuity in the better-seeing eye was constructed to simulate the costs and consequences of patients taking AREDS vitamin supplements. Setting: UK National Health Service (NHS). The model was populated with data from AREDS and real-world outcomes and resource use from a prospective multicentre national nAMD database study containing 92 976 ranibizumab treatment episodes.InterventionsTwo treatment approaches were compared: immediate intervention with AREDS supplements or no supplements. Main outcome measures: quality-adjusted life years (QALYs) and healthcare costs were accrued for each strategy, and incremental costs and QALYs were calculated for the lifetime of the patient. One-way and probabilistic sensitivity analyses were employed to test the uncertainty of the model.ResultsFor AREDS category 3, the incremental cost-effectiveness ratio was £30 197. For AREDS category 4 compared with no intervention, AREDS supplements are more effective (10.59 vs 10.43 QALYs) and less costly (£52 074 vs 54 900) over the lifetime of the patient.ConclusionsThe recommendation to publicly fund AREDS supplements to category 3 patients would depend on the healthcare system willingness to pay. In contrast, initiating AREDS supplements in AREDS category 4 patients is both cost saving and more effective than no supplement use and should therefore be considered in public health policy.

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