MyVisionTest News Archive
Apr 15, 2009
Forecasting AMD prevalence and impact in the United States
A new study of age-related macular degeneration (AMD) in the United States finds that the prevalence of AMD will increase substantially over the next several decades, but new treatments will help to mitigate the number of people that will suffer severe vision loss from the disease.
Newly discovered therapies for AMD could potentially offset some of the severe vision loss that would otherwise be expected to occur with the aging of the US population. Preventive therapies include antioxidant vitamins that could slow the progression of AMD from early to late stages. Treatments for more advanced forms of the disease include laser and photodynamic therapies and anti-VEGF injections, which can improve vision or prevent further vision loss.
This study simulated cases of early AMD, choroidal neovascularization (CNV), geographic atrophy (GA), and AMD-attributable visual impairment and blindness with possible scenarios:
(1) no treatment;
(2) focal laser and photodynamic therapy (PDT) for CNV;
(3) vitamin prophylaxis at early-AMD incidence with focal laser/PDT for CNV;
(4) no vitamin prophylaxis followed by focal laser treatment for extra and juxtafoveal CNV and anti–vascular endothelial growth factor treatment;
(5) vitamin prophylaxis at early-AMD incidence followed by CNV treatment, as in scenario 4.
Cases of early AMD increased from 9.1 million in 2010 to 17.8 million in 2050 across all scenarios. In non–vitamin-receiving scenarios, cases of CNV and GA increased from 1.7 million in 2010 to 3.8 million in 2050 (25% lower in vitamin-receiving scenarios). Cases of visual impairment and blindness increased from 620 000 in 2010 to 1.6 million in 2050 when given no treatment and were 2.4%, 22.0%, 16.9%, and 34.5% lower in scenarios 2, 3, 4, and 5, respectively.
The statistical model predicts large increases in both early and advanced AMD and associated visual impairment over the next 40 years regardless of the treatment steps taken, with virtually all of these increases attributable to the aging of the U.S. population. However, existing medical therapies have the potential to reduce the visual impairment and blindness attributable to AMD by as much as 35 percent, translating to 565,000 fewer cases of visual impairment and blindness in 2050.
With an annual cost of approximately $100 per patient, vitamin therapy is a cost-effective method of delaying AMD progression, but research indicates it is not widely used among patients with early-stage disease. Public prevention efforts should focus on expanding the use of antioxidant vitamins in people with early AMD and ensuring that these patients use the correct dosage. Efforts should also be undertaken to improve access to anti-VEGF and laser therapies for eligible patients.
In summary, the prevalence of AMD will increase substantially by 2050, but the use of new therapies can mitigate its effects.
Read more...
Arch Ophthalmol. 2009 Apr;127(4):533-40
Tags: vitamin therapy, VEGF, photodynamic therapy, AMD
A new study of age-related macular degeneration (AMD) in the United States finds that the prevalence of AMD will increase substantially over the next several decades, but new treatments will help to mitigate the number of people that will suffer severe vision loss from the disease. Newly discovered therapies for AMD could potentially offset some of the severe vision loss that would otherwise be expected to occur with the aging of the US population. Preventive therapies include antioxidant vitamins that could slow the progression of AMD from early to late stages. Treatments for more advanced forms of the disease include laser and photodynamic therapies and anti-VEGF injections, which can improve vision or prevent further vision loss.
(1) no treatment;
(2) focal laser and photodynamic therapy (PDT) for CNV;
(3) vitamin prophylaxis at early-AMD incidence with focal laser/PDT for CNV;
(4) no vitamin prophylaxis followed by focal laser treatment for extra and juxtafoveal CNV and anti–vascular endothelial growth factor treatment;
(5) vitamin prophylaxis at early-AMD incidence followed by CNV treatment, as in scenario 4.
Cases of early AMD increased from 9.1 million in 2010 to 17.8 million in 2050 across all scenarios. In non–vitamin-receiving scenarios, cases of CNV and GA increased from 1.7 million in 2010 to 3.8 million in 2050 (25% lower in vitamin-receiving scenarios). Cases of visual impairment and blindness increased from 620 000 in 2010 to 1.6 million in 2050 when given no treatment and were 2.4%, 22.0%, 16.9%, and 34.5% lower in scenarios 2, 3, 4, and 5, respectively.
The statistical model predicts large increases in both early and advanced AMD and associated visual impairment over the next 40 years regardless of the treatment steps taken, with virtually all of these increases attributable to the aging of the U.S. population. However, existing medical therapies have the potential to reduce the visual impairment and blindness attributable to AMD by as much as 35 percent, translating to 565,000 fewer cases of visual impairment and blindness in 2050.
With an annual cost of approximately $100 per patient, vitamin therapy is a cost-effective method of delaying AMD progression, but research indicates it is not widely used among patients with early-stage disease. Public prevention efforts should focus on expanding the use of antioxidant vitamins in people with early AMD and ensuring that these patients use the correct dosage. Efforts should also be undertaken to improve access to anti-VEGF and laser therapies for eligible patients.
In summary, the prevalence of AMD will increase substantially by 2050, but the use of new therapies can mitigate its effects.
Read more...
Arch Ophthalmol. 2009 Apr;127(4):533-40
