Prevalence of age-related macular degeneration among optometric telemedicine users in Spain: a retrospective nationwide population-based study

Abstract

Purpose

To evaluate the prevalence of AMD among optometric telemedicine users in Spain and to identify risk factors.

Methods

Retrospective analysis of a nationwide database conducted on subjects attending to optometry centers, between January 2013 and December 2019. Fundus photographs were performed by optometrists, using non-mydriatic cameras, and evaluated by a group of 12 retina specialists.

Results

Among the 119,877 subjects included, the overall prevalence of AMD was 7.6%. The prevalence of early, intermediate, and advanced AMD was 2.9%, 2.7%, and 2.0%, respectively. Of the 9129 AMD subjects, 1161 (12.7%) had geographic atrophy, and 1089 (11.9%) had neovascular AMD, either scar (4.5%) or exudative (7.4%). There was a significant association between AMD and age (per year older, adjusted odds ratio, OR 1.116; 95% CI 1.114 to 1.119, p<0.0001). Women had higher prevalence (adjusted OR 1.17; 95% CI 1.12 to 1.23, p<0.0001). Every diopter (spherical equivalent) of progress toward hyperopia was associated with a significant increase in early AMD prevalence (adjusted OR 1.02, 95 CI 1.01 to 1.04, p=0.0074). Presence of diabetes was associated with a lower AMD prevalence (p<0.0001).

Conclusions

The prevalence of AMD (any eye and any severity) was 7.6%, with a prevalence of advanced AMD of 2.0%. Older age and women were significantly associated with a higher prevalence of AMD, whereas myopia and presence of diabetes were associated with significantly lower odds of any AMD.

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Abbreviations

VI:

Álava

AB:

Albacete

A:

Alicante

AL:

Almería

O:

Asturias

AV:

Ávila

BA:

Badajoz

IB:

Balearic Islands

B:

Barcelona

BU:

Burgos

CC:

Caceres

CA:

Cádiz

S:

Cantabria

CS:

Castellon

CE:

Ceuta

CR:

Ciudad Real

CO:

Córdoba

C:

Coruña

CU:

Cuenca

GI:

Gerona

GR:

Granada

GU:

Guadalajara

SS:

Gipuzkoa

H:

Huelva

HU:

Huesca

J:

Jaen

LE:

León

L:

Lerida

LU:

Lugo

M:

Madrid

MA:

Málaga

MU:

Murcia

NA:

Navarre

OU:

Orense

P:

Palencia

GC:

Las Palmas

PO:

Pontevedra

LO:

La Rioja

SA:

Salamanca

SG:

Segovia

SE:

Seville

SO:

Soria

T:

Tarragona

TF:

Tenerife

TE:

Teruel

TO:

Toledo

V:

Valencia

VA:

Valladolid

BI:

Vizcaya

ZA:

Zamora

Z:

Zaragoza

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Acknowledgements

Medical writing and editorial assistant services have been provided by Ciencia y Deporte S.L. and covered by a Grant from Allergan.

Optretina reading group

Miguel A Zapata (MD, PhD)1,2; Gabriel Arcos (MD)3,4; Anniken Burés (MD,PhD)3,5; Alex Fonollosa (MD, PhD)3,6; Ignacio Flores-Moreno (MD, PhD)3,7; Roberto Gallego-Pinazo (MD, PhD)3,8; Estanislao Gutiérrez (MD, PhD)3,9; Andrea Oléñik (MD, PhD)3; Salvador Pastor (MD, PhD)3,10; Jorge Ruiz-Medrano (MD, PhD, FEBO)3,7; Cecilia Salinas(MD)3,5; Maximino Abraldes (MD, PhD)3,11

Affiliations

1Optretina. Barcelona (Spain)

2Hospital Vall Hebron. Barcelona (Spain)

3Retinal specialist, retina readers. Barcelona (Spain)

4AMEDICS, Barcelona (Spain)

5IMO, Instituto de Microcirugía Ocular, Barcelona (Spain)

6Hospital de Cruces, Bilbao (Vizcaya, Spain)

7Hospital Puerta de Hierro, Madrid (Spain)

8Oftalvist, Valencia (Spain)

9Hospital Universitario Virgen Macarena, Sevilla (Spain)

10Hospital Clínico Universitario, Valladolid (Spain)

11Complexo Hospitalario Universitario de Santiago de Compostela (A Coruña, Spain)

Funding

Support for this assistance was funded by Allergan S.A.

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Corresponding author

Correspondence to Miguel A. Zapata.

Ethics declarations

Statement of ethics

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Hospital Vall d’Hebron (Barcelona, Spain).

Consent to participate

Patients were fully informed about the study objectives and its limitations, and written informed consent was obtained before any test were carried out.

Competing interests

Dr. Miguel A Zapata has received a Grant from Allergan during the conduct of the study for medical writing and editorial assistant services. All other authors declare that they have no conflict of interest in this paper.

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Supplementary information

Figure S1.
figure4

Prevalence of age-related macular degeneration (AMD) (any eye and any severity) in the different Spanish provinces. (PNG 98 kb)

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Table S1

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Zapata, M.A., Burés, A., Gallego-Pinazo, R. et al. Prevalence of age-related macular degeneration among optometric telemedicine users in Spain: a retrospective nationwide population-based study. Graefes Arch Clin Exp Ophthalmol (2021). https://doi.org/10.1007/s00417-021-05093-4

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Keywords

  • Age-related macular degeneration
  • Epidemiology
  • Macula
  • Prevalence
  • Retinal disorders
  • Retina
  • Risk factors
  • Telemedicine