AMD, DED most common retinal conditions in the United States

The number of patients with retinal diseases such as age-related macular degeneration (AMD), retinal vein occlusion, and diabetic eye disease is steadily increasing in the United States, according to a retrospective study presented during ARVO 2020.

Tatiana Rosenblatt, Byers Eye Institute, Stanford University School of Medicine, and colleagues examined electronic medical records from the Vestrum Health Retina Database between January 2014 and December 2019 to determine the prevalence of common retinal diseases in the United States.

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“Population-based epidemiological studies have provided us with invaluable insights into retinal disease prevalence and incidence,” Ms. Rosenblatt said. “However, these studies have yielded heterogeneous estimates, as they have been drawn from disparate countries or single sites over nonoverlapping time periods. As such, an updated estimate of the current incidence and prevalence of common retinal diseases in the United States is warranted.”

Study design
More than 6 million eyes were evaluated from 58 geographically diverse retina practices. To be included in the retrospective study, eyes had to have one of the following diseases:

• Dry AMD, including geographic atrophy
• Wet AMD
• Diabetic macular edema (DME)
• Diabetic retinopathy (DR)
• Branch retinal vein occlusion (BRVO)
• Central retinal vein occlusion (CRVO)

Researchers calculated the annual and total incidence of eyes first diagnosed with the condition per year, as well as across the entire 6-year study period.

They also calculated the annual and total prevalence as the distinct number of eyes seen with an associated condition. Six-year prevalence was also stratified by geographic region and age.

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Results
Dry AMD had the largest disease burden over the 6-year period with a 16.3% prevalence. Wet AMD followed, with a prevalence of 13.2%.

“Prevalence for wet and dry AMD increased annually,” Ms. Rosenblatt said. “Dry AMD had the largest prevalence of all the diseases surveyed. In total, AMD, both wet and dry, was the most prevalent disease.”

Further, AMD prevalence increased with age, peaking in the 80- to 89-year-old age group.

For diabetic eye diseases, about 10% of patients had DME and about 8% had DR without DME.

“Diabetic eye disease as a whole, including both DME and DR, had the second largest incidence,” Ms. Rosenblatt said. “Incidence of DME and DR without DME increased annually. Incidence especially increased for DR without DME from 2018 to 2019, which may be due to the growing rates of diabetes in the United States.”

Unlike AMD, diabetic eye disease prevalence peaked in patients aged 60 to 69 years and dropped off in the older age group.

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Retinal vein occlusions had the lowest incidence of all of the diseases studied, at 2.6% (BRVO) and 1.8% (CRVO).

“BRVO and CRVO both peaked in the middle age groups, with a decline in the older age groups. There was also a smaller peak noted in patients less than 55 years old, likely due to the sheer volume of patients in that age group,” Ms. Rosenblatt explained.

The trends were consistent when broken out by geographic area, with AMD and diabetic eye disease accounting for most of the cases.

The study results confirm that the majority of patients in retina practices in the United States are treated for AMD and diabetic eye disease.

Read more by Michelle Dalton