SILK, Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Finnish Register of Visual Impairment, Finnish Federation of the Visually Impaired, Helsinki, Finland.
Acta Ophthalmol. 2023 Feb;101(1):57-64. doi: 10.1111/aos.15224. Epub 2022 Aug 1.
To evaluate the changes in visual impairment (VI) due to age-related macular degeneration (AMD) during the past 40 years and the impact of novel therapies at population level.
In this nationwide register-based study, we assessed the incidence, prevalence, severity, and onset age of VI due to AMD based on the Finnish Register of Visual Impairment data from 1980 to 2019. Our data included 30 016 visually impaired persons with AMD as the main diagnosis for VI. The number of persons treated with intravitreal injections in Finland was obtained from hospital data kept by the Finnish Institute for Health and Welfare.
Between the 1980s and the 2010s, the incidence of reported VI doubled; however, this increase has stagnated in the 2010s. Since 2012, the prevalence of reported VI has decreased. The number of patients treated with intravitreal injections showed a 40-fold increase during 2005-2019. The severity of reported VI has decreased whereas the mean age at the onset of reported VI has increased during the 40 years. The age-adjusted incidence and prevalence of reported VI were significantly higher in females in comparison to males in all decades.
Increase in the incidence and prevalence of VI due to AMD in the past decades has stagnated and shifted to older age in the 2010s when therapies for exudative class became commonly available. Furthermore, the prognosis of VI has improved during the past 40 years. These positive trends are likely contributable to improved diagnostic tools, earlier diagnoses, and new therapy options.
评估过去 40 年来与年龄相关的黄斑变性（AMD）相关的视力障碍（VI）变化以及新型疗法对人群的影响。
在这项全国范围内基于登记的研究中，我们根据芬兰视力障碍登记数据评估了 1980 年至 2019 年期间与 AMD 相关的 VI 的发病率、患病率、严重程度和发病年龄。我们的数据包括 30016 名因 AMD 导致 VI 的视力受损者。芬兰眼科研究所保存的医院数据提供了在芬兰接受玻璃体内注射治疗的人数。
在 20 世纪 80 年代至 2010 年代期间，报告的 VI 发病率增加了一倍；然而，这种增长在 2010 年代已经停滞不前。自 2012 年以来，报告的 VI 患病率有所下降。2005 年至 2019 年期间，接受玻璃体内注射治疗的患者人数增加了 40 倍。报告的 VI 的严重程度有所下降，而报告的 VI 的发病平均年龄在过去 40 年中有所增加。在所有十年中，女性报告的 VI 的年龄调整发病率和患病率均明显高于男性。
过去几十年中，AMD 导致的 VI 的发病率和患病率增加已经停滞，并在 2010 年代转移到年龄更大的人群，当时渗出性 AMD 的治疗方法已普遍可用。此外，过去 40 年来，VI 的预后有所改善。这些积极的趋势可能归因于改进的诊断工具、更早的诊断和新的治疗选择。
