Incidence and prevalence of neovascular age-related macular degeneration: 15-year epidemiological study in a population-based cohort in Finland

BACKGROUND/OBJECTIVES: Neovascular age-related macular degeneration (nAMD) is a common cause for visual impairment in the ageing population. An increasing number of nAMD patients causes significant health burden, although intravitreal anti-VEGF agents have revolutionized nAMD treatment during the past 15 years. We aimed to define incidence and prevalence of nAMD in different age-categories in the anti-VEGF era and to estimate the number of the individuals over 75 years of age in 2050. PATIENTS AND METHODS: We conducted an epidemiological study of the nAMD cohort (n = 2121) in a Finnish population of 410,000 inhabitants. Demographic and clinical data were gathered from Oulu University Hospital’s database during 2006–2020. The incidence and prevalence rates were calculated using population data from national registers. The three-year moving average of incidence of nAMD per 100,000 person years was estimated. Prevalence figures were calculated per 100,000 age-specific inhabitants. RESULTS: The average age at the diagnosis of nAMD was 78土8 years, and 62% of the patients were women. The incidence of nAMD was 71 (95% CI 55–90) and 102 (95% CI 88–118) per 100,000 person years in 2006 and 2020, respectively. During 2006–2020, 1.2- and 2.4-fold increases in nAMD incidence were noted in 75–84 and in 85–96 age groups, respectively. In the oldest 75–84 and 85–96 age categories the nAMD prevalence was 2865/100,000 (3%, 95% CI 2665–3079) and 2620/100,000 (3%, 95% CI 2323–2956), respectively. The proportion of the inhabitants >75 years old is estimated to increase from 10% in 2020 to 17% by 2050. CONCLUSIONS: Our results indicate constant 1.2- and 2.4-fold increases in nAMD incidence during the past 15 years in age groups of 75–84 and 85–96 years, respectively, and 3% prevalence of nAMD in 2020. An almost two-fold increase in the ageing population by the year 2050 may also predict the trends in nAMD. KEY MESSAGES: The results of the current population-based study indicate 1.2- and 2.4-fold increases in the incidence of neovascular AMD (nAMD) during the last 15 years in the Finnish population aged 75–84 and 85–96 years and 3% prevalence of nAMD in 2020. An almost two-fold increase in the number of individuals over 75 years of age by the year 2050 is estimated, which may also predict the trends in nAMD. Intravitreal anti-vascular endothelial growth factor (anti-VEGF)- agents have revolutionized the treatment and prognosis of nAMD. Timely recognition and referral of nAMD patients to ophthalmologist can ensure vision-related functionality especially among the ageing population.