Owen C G, Fletcher A E, Donoghue M, Rudnicka A R
Department of Public Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
Br J Ophthalmol. 2003 Mar;87(3):312-7. doi: 10.1136/bjo.87.3.312.
To predict the burden of blindness, partial sight, and visual impairment (binocular visual acuity 6/18 or less) due to late stage age related macular degeneration (AMD) in the ageing population of the United Kingdom.
A systematic review, followed by a request for data, was used to establish a pooled prevalence of AMD and corresponding visual loss. Prevalence figures were applied to the UK population. Using UK population trends, the future burden of AMD over the coming decade was established.
Pooled data from six studies showed that the prevalence of visual loss caused by AMD increased exponentially from the age of 70-85 years of age, with 3.5% (95% CI 3.0 to 4.1) having visual impairment beyond the age of 75 years. The authors estimate that there are currently 214 000 (95% CI 151 000 to 310 000) with visual impairment caused by AMD (suitable for registration). This number is expected to increase to 239 000 (95% CI 168 000 to 346 000) by the year 2011. Currently there are 172 000 (95% CI 106 000 to 279 000) and 245 000 (95% CI 163 000 to 364 000) with geographical and neovascular AMD, respectively.
Estimates of visual impairment agree with official statistics for the number registered partially sighted or blind, caused by AMD, and are well below other figures often cited. Although these estimates are associated with wide confidence intervals (CI) and a number of caveats, they represent the best available data, which can be used to guide health and social care provision for older people in the UK setting. Implications for low vision services are outlined.
预测英国老年人群中因晚期年龄相关性黄斑变性(AMD)导致的失明、视力部分丧失及视力损害(双眼视力6/18或更低)的负担。
通过系统综述并随后索取数据,以确定AMD的合并患病率及相应的视力丧失情况。将患病率数据应用于英国人口。利用英国人口趋势,确定未来十年AMD的负担情况。
六项研究的汇总数据显示,由AMD导致的视力丧失患病率在70至85岁年龄段呈指数增长,75岁以上人群中有3.5%(95%置信区间3.0至4.1)存在视力损害。作者估计,目前有214000例(95%置信区间151000至310000)因AMD导致视力损害(适合登记)。预计到2011年,这一数字将增至239000例(95%置信区间168000至346000)。目前,分别有172000例(95%置信区间106000至279000)和245000例(95%置信区间163000至364000)患有地图样萎缩性和新生血管性AMD。
视力损害的估计与AMD导致的部分视力受损或失明登记人数的官方统计数据一致,且远低于其他经常引用的数字。尽管这些估计存在较宽的置信区间(CI)及一些限制条件,但它们代表了现有最佳数据,可用于指导英国老年人群的健康和社会护理服务提供。概述了对低视力服务的影响。