Variations and trends in global disease burden of age-related macular degeneration: 1990-2017.

Abstract

To evaluate the disease burden of age-related macular degeneration (AMD) and to evaluate the risk factors of disability-adjusted life years (DALY) caused by AMD. Country-specific DALY number, rate and age-standardized rate of AMD were acquired from the Global Burden of Disease Study 2017 database. The Socio-demographic Index (SDI), Human Development Index (HDI), Inequality-adjusted Human Development Index (IA-HDI) and other related data were obtained from published data or shared databases. Regression analysis was conducted to evaluate the correlations between the potential risk factors and the age-standardized DALY rate of AMD. The DALY number doubled from 1990 to 2017, and DALY rate increased from 4.73 (95% CI: 3.19-6.54) to 6.95 (95% CI: 4.76-9.54). However, change was small after standardizing. Females tended to have severer burden. Disability-adjusted life years (DALY) rates were correlated to annual PM2.5 concentration, gross domestic product (GDP) per capita, population with at least some secondary education (secondary education), glaucoma prevalence and gross national income (GNI) per capita. In SDI model, glaucoma, GDP, healthcare access and quality index (HAQ) and secondary education were associated with disease burden (p<0.001). In IA-HDI model, cataract, glaucoma, PM2.5, GDP and secondary education were correlated to DALY rates (p<0.001). In model included four components of HDI, glaucoma, PM2.5, GDP, secondary education, expected years of schooling and life expectancy at birth were associated (p<0.001). Being female, older age, poor socioeconomic status and less educated are associated with a heavier disease burden of AMD. These findings would provide a basic understanding for policy making on AMD prevention and treatment.