Incidence and Prevalence of Neovascular Age-Related Macular Degeneration in France between 2008 and 2018: The LANDSCAPE Study

Abstract

Purpose: This study aimed to estimate the incidence and prevalence of neovascular age-related macular degeneration (nAMD) in the French population between 2008 and 2018.

Design: This was a retrospective, longitudinal population study using health care consumption data from the Système National des Données de Santé (SNDS; the French National Health Information Database), which covers approximately 99% of the French population.

Participants: We identified individuals treated for nAMD from the French population 50 years of age and older. Identification criteria were nAMD diagnosis or reimbursement of nAMD treatments (anti-vascular endothelial growth factor intravitreal injection or dynamic phototherapy with verteporfin). Exclusion criteria were high myopia, diagnosis of other retinal diseases, and other treatments for macular diseases (dexamethasone implant, laser therapy, etc.).

Methods: We calculated incidence and prevalence based on the age-matched general population in France. Adjustment for age and sex was also performed for incidence.

Main outcome measures: Incidence and prevalence of nAMD in the French population between 2008 and 2018.

Results: Between 2008 and 2018, we identified 342 961 patients with nAMD (67.5% women). Mean ± standard deviation age at nAMD diagnosis or first treatment increased from 78.8 ± 8.1 years in 2008 to 81.2 ± 7.9 years in 2018. In 2018, annual incidence was 0.149% and prevalence was 1.062% for the French population 50 years of age or older. Incidence was stable over the 10-year period. Annual incidence increased with age (0.223%, 0.380%, and 0.603% in those 60 years of age or older, 70 years of age or older, and 80 years of age or older, respectively), with similar trends for prevalence. No major differences were observed among the 14 regions of France for incidence or prevalence. Neovascular age-related macular degeneration incidence in 2018 was not impacted by the availability of primary or ophthalmology care in patients' localities.

Conclusions: The LANDSCAPE study provides exhaustive nationwide data on incidence and prevalence of nAMD in France over a 10-year period.

Keywords: AMD, age-related macular degeneration; Age-related macular degeneration; France; ICD-10, International Classification of Diseases, Tenth Revision; Incidence; Neovascular; Prevalence; SNDS, Système National des Données de Santé (National Health Information Database); VEGF, vascular endothelial growth factor; nAMD, neovascular age-related macular degeneration.

Figure 1

Line graph showing the incidence of neovascular age-related macular degeneration from 2008 through 2018. The incidence is standardized to the corresponding population in France 50 years of age or older by age and sex. Incidence in expressed per 100 inhabitants.

Figure 2

Bar graph showing the incidence of neovascular age-related macular degeneration in 2018 per age category. The incidence is standardized to the corresponding population in France 50 years of age or older by age and sex. Incidence in expressed per 100 inhabitants.

Figure 3

Map showing the incidence of neovascular age-related macular degeneration in 2018 per region in France. The incidence is standardized to the corresponding population in France 50 years of age or older by age and sex. Incidence in expressed per 100 inhabitants.

Figure 4

Bar graphs showing the incidence of neovascular age-related macular degeneration in 2018 by (A) frequency of general practitioners, (B) frequency of ophthalmologists in residential area, and (C) classification of patients' residential area.