An epidemiological study of neovascular age-related macular degeneration in Germany

Abstract

Objective:

Neovascular or wet age-related macular degeneration (AMD) is one of the leading causes of blindness in industrialized countries; however, there is a lack of recent epidemiological data from Germany. The aim of this study was to collect epidemiological data from patients in Germany with suspected neovascular AMD and evaluate the diagnostic procedures performed and treatments used at clinics.

Methods:

This was a Germany-based, multicentre, retrospective review of data from patients with suspected neovascular AMD visiting ophthalmology clinics over an 18 month period in 2008–10. Clinical characteristics, functional symptoms and examination results were recorded. In addition, ophthalmologists completed a questionnaire on neovascular AMD diagnosis and treatment.

Results:

Ten sites collected data from 2498 patients (64.0% female) with a mean decimal visual acuity of 0.4 ± 0.3 at the time of diagnosis of neovascular AMD. The mean age at the time of diagnosis was 76.9 ± 8.9 years for patients with the right eye affected and 77.0 ± 8.3 years for patients with the left eye affected. The most frequent pathological findings detected by routine ophthalmic examination were old lesions (31.2%), intra/subretinal fluid (18.1%), new lesions (13.0%), and intra/subretinal haemorrhage (11.4%). A confirmed diagnosis of neovascular AMD was most frequently based on fundoscopy (67.3%), fluorescein angiography (39.6%), and biomicroscopy (35.7%) tests but rarely on optical coherence tomography (8.9%). The most frequently documented comorbidity with neovascular AMD was hypertension and other cardiovascular diseases (57.5%). Seven ophthalmologists completed the questionnaire with the majority of ophthalmologists agreeing that regular ophthalmic examination can prevent the development of late-stage neovascular AMD.

Conclusion:

Neovascular AMD is a frequent diagnosis in German ophthalmology clinics. As visual acuity is already poor in most patients with suspected neovascular AMD, regular preventive ophthalmologic examinations should be considered in high risk patients.

Study limitations:

Limitations of the study include the lack of a comparator cohort, which limited the amount of analyses that could be performed. Additionally, a study eye was not defined and information was collected separately for each affected eye and therefore analysed separately. Furthermore, a small number of ophthalmologists completed the questionnaire, limiting the objectivity.

Keywords::

• AMD diagnosis
• AMD epidemiology
• AMD treatment
• Neovascular age-related macular degeneration
• Optical coherence tomography

Transparency

Declaration of funding

This study was sponsored by Novartis Pharmaceuticals, Nuremberg, Germany.

Declaration of financial/other relationships

L.K. acts as a speaker for Novartis, Bayer and Alcon, and has participated in clinical studies for Novartis and Santen. T.Y. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article. K.P. is an employee of Novartis Pharma GmbH, Nuremberg, Germany. All authors have full control of all primary data and they agree to allow Current Medical Research and Opinion to review their data upon request.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgements

CAPTAIN study group: Lothar Krause, Arne Beckendorf, Kathrin Böhm, Sören-Chr. Egger, Matthias Hartmann, Monika Hassinger, Rainer Langkau, Babak Mohammadi, Dieter Riebsamen, Renate Tesnau, Tarik Yousif, Karin Pohl, Ilya Mochkin. The authors thank Fishawack Communications, UK and CRO Kantar Health, Germany for support in preparing this publication; these services were funded by Novartis Pharmaceuticals, Nuremberg, Germany.