Skip to main content

Advertisement

SpringerLink
Log in

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

  • Medical Ophthalmology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

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

References

  1. Klein R, Klein BE, Linton KL (1992) Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology. 99(6):933–943. https://doi.org/10.1016/s0161-6420(92)31871-8

    Article  CAS  PubMed  Google Scholar 

  2. Mitchell P, Smith W, Attebo K, Wang JJ (1995) Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study. Ophthalmology. 102(10):1450–1460. https://doi.org/10.1016/s0161-6420(95)30846-9

    Article  CAS  PubMed  Google Scholar 

  3. Vingerling JR, Dielemans I, Hofman A, Grobbee DE, Hijmering M, Kramer CF, de Jong PT (1995) The prevalence of age-related maculopathy in the Rotterdam Study. Ophthalmology. 102:205–210. https://doi.org/10.1016/s0161-6420(95)31034-2

    Article  CAS  PubMed  Google Scholar 

  4. Vannewkirk MR, Nanjan MB, Wang JJ, Mitchell P, Taylor HR, McCarty CA (2000) The prevalence of age-related maculopathy: the visual impairment project. Ophthalmology. 107:1593–1600. https://doi.org/10.1016/s0161-6420(00)00175-5

    Article  CAS  PubMed  Google Scholar 

  5. Augood CA, Vingerling JR, de Jong PT, et al (2006). Prevalence of age-related maculopathy in older Europeans: the European Eye Study (EUREYE). Arch Ophthalmol. 124(4):529-535. doi: https://doi.org/10.1001/archopht.124.4.529.

  6. Kawasaki R, Yasuda M, Song SJ, Chen SJ, Jonas JB, Wang JJ, Mitchell P, Wong TY (2010) The prevalence of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology. 117(5):921–927. https://doi.org/10.1016/j.ophtha.2009.10.007

    Article  PubMed  Google Scholar 

  7. Korb CA, Kottler UB, Wolfram C, Hoehn R, Schulz A, Zwiener I, Wild PS, Pfeiffer N, Mirshahi A (2014) Prevalence of age-related macular degeneration in a large European cohort: results from the population-based Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol 252(9):1403–1411. https://doi.org/10.1007/s00417-014-2591-9

    Article  PubMed  Google Scholar 

  8. Wong WL, Su X, Li X et al (2014) Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health 2(2):e106–e116. https://doi.org/10.1016/S2214-109X(13)70145-1

    Article  PubMed  Google Scholar 

  9. García-Layana A, Cabrera-López F, García-Arumí J, Arias-Barquet L, Ruiz-Moreno JM (2017) Early and intermediate age-related macular degeneration: update and clinical review. Clin Interv Aging 12:1579–1587. https://doi.org/10.2147/CIA.S142685

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lüdtke L, Jürgens C, Ittermann T, Völzke H, Tost F (2019) Age-related macular degeneration and associated risk factors in the population-based study of health in Pomerania (SHIP-Trend). Med Sci Monit 25:6383–6390. https://doi.org/10.12659/MSM.915493

    Article  PubMed  PubMed Central  Google Scholar 

  11. Klein R, Klein BEK, Linton KLP (2020) Prevalence of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology. 127(4S):S122–S132. https://doi.org/10.1016/j.ophtha.2020.01.033

    Article  PubMed  Google Scholar 

  12. Pennington KL, DeAngelis MM (2016) Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors. Eye Vis (Lond) 3:34. https://doi.org/10.1186/s40662-016-0063-5

    Article  Google Scholar 

  13. Serrano-Garijo P, Ramírez-Sebastián JM (1991) Detección de las alteraciones visuales en el anciano. Rev Esp Geriatr Gerontol. 26:21–28

    Google Scholar 

  14. Lago Bouza JR. Prevalencia de la degradación macular asociada a la edad en una población hospitalaria del área sanitaria de Santiago de Compostela. Available in https://dialnet.unirioja.es/servlet/tesis?codigo=109565 Last accessed July 30, 2020.

  15. Damián J, Pastor R, Armadá F, Arias L (2006) Epidemiología de la degeneración macular asociada con la edad. Situación en España. Aten Primaria 38(1):51–57. https://doi.org/10.1157/13090016

    Article  PubMed  PubMed Central  Google Scholar 

  16. Zapata MA, Arcos G, Fonollosa A, Abraldes M, Oleñik A, Gutierrez E, Garcia-Arumi J (2017) Telemedicine for a general screening of retinal disease using nonmydriatic fundus cameras in optometry centers: three-year results. Telemed J E Health. 23(1):30–36. https://doi.org/10.1089/tmj.2016.0020

    Article  PubMed  Google Scholar 

  17. Authors not listed. Diabetic eye screening: guidance on camera approval. Updated January 3, 2018. Available in: https://www.gov.uk/government/publications/diabetic-eye-screening-approved-cameras-and-settings/diabetic-eye-screening-guidance-on-camera-approval Last accessed July 30, 2020.

  18. Ferris FL 3rd, Wilkinson CP, Bird A, Chakravarthy U, Chew E, Csaky K, Sadda SR, Beckman Initiative for Macular Research Classification Committee (2013) Clinical classification of age-related macular degeneration. Ophthalmology. 120(4):844–851. https://doi.org/10.1016/j.ophtha.2012.10.036

    Article  PubMed  Google Scholar 

  19. 1. Instituto nacional de estadística (INE) [Internet]. INE. 2020. Available at: https://www.ine.es/jaxi/Tabla.htm?path=/t20/e245/p08/l0/&file=01002.px&L=0. Accessed 15th Oct 2020

  20. Erke MG, Bertelsen G, Peto T, Sjølie AK, Lindekleiv H, Njølstad I (2012) Prevalence of age-related macular degeneration in elderly Caucasians: the Tromsø Eye Study. Ophthalmology. 119(9):1737–1743. https://doi.org/10.1016/j.ophtha.2012.03.016

    Article  PubMed  Google Scholar 

  21. Owen CG, Jarrar Z, Wormald R, Cook DG, Fletcher AE, Rudnicka AR (2012) The estimated prevalence and incidence of late stage age related macular degeneration in the UK. Br J Ophthalmol. 96(5):752–756. https://doi.org/10.1136/bjophthalmol-2011-301109

    Article  PubMed  Google Scholar 

  22. van Leeuwen R, Boekhoorn S, Vingerling JR, Witteman JC, Klaver CC, Hofman de Jong PT (2005) Dietary intake of antioxidants and risk of age-related macular degeneration. JAMA 294(24):3101–3107. https://doi.org/10.1001/jama.294.24.3101

    Article  PubMed  Google Scholar 

  23. Arslan S, Kadayifçilar S, Samur G (2019) The potential role of dietary antioxidant capacity in preventing age-related macular degeneration. J Am Coll Nutr. 38(5):424–432. https://doi.org/10.1080/07315724.2018.1538830

    Article  CAS  PubMed  Google Scholar 

  24. Evans JR, Lawrenson JG (2017) Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 7:CD000253. https://doi.org/10.1002/14651858.CD000253.pub4

    Article  PubMed  Google Scholar 

  25. Olmedo-Requena R, González-Donquiles C, Dávila-Batista V, Romaguera D, Castelló A, Molina de la Torre AJ et al (2019) Agreement among Mediterranean diet pattern adherence indexes: MCC-Spain study. Nutrients. 11(3):488. https://doi.org/10.3390/nu11030488

    Article  PubMed Central  Google Scholar 

  26. Spanish Eyes Epidemiological (SEE) Study Group (2011) Prevalence of age-related macular degeneration in Spain. Br J Ophthalmol. 95(7):931–936. https://doi.org/10.1136/bjo.2010.187773

    Article  Google Scholar 

  27. Smith W, Assink J, Klein R, Mitchell P, Klaver CC, Klein BE, Hofman A, Jensen S, Wang JJ, de Jong PT (2001). Risk factors for age-related macular degeneration: pooled findings from three continents. Ophthalmology 108(4):697-704. https://doi.org/10.1016/s0161-6420(00)00580-7.

  28. Evans JR, Fletcher AE, Wormald RP (2004) Age-related macular degeneration causing visual impairment in people 75 years or older in Britain: an add-on study to the Medical Research Council Trial of Assessment and Management of Older People in the Community. Ophthalmology. 111(3):513–517. https://doi.org/10.1016/j.ophtha.2003.07.012

    Article  PubMed  Google Scholar 

  29. Wang JJ, Mitchell P, Smith W (1998) Refractive error and age-related maculopathy: the Blue Mountains Eye Study. Invest Ophthalmol Vis Sci. 39(11):2167–2171

    CAS  PubMed  Google Scholar 

  30. Ikram MK, van Leeuwen R, Vingerling JR, Hofman A, de Jong PT (2003) Relationship between refraction and prevalent as well as incident age-related maculopathy: the Rotterdam study. Invest Ophthalmol Vis Sci. 44(9):3778–3782. https://doi.org/10.1167/iovs.03-0120

    Article  PubMed  Google Scholar 

  31. Pallikaris IG, Kymionis GD, Ginis HS, Kounis GA, Christodoulakis E, Tsilimbaris MK (2006) Ocular rigidity in patients with age-related macular degeneration. Am J Ophthalmol. 141(4):611–615. https://doi.org/10.1016/j.ajo.2005.11.010

    Article  PubMed  Google Scholar 

  32. He MS, Chang FL, Lin HZ, Wu JL, Hsieh TC, Lee YC (2018) The association between diabetes and age-related macular degeneration among the elderly in Taiwan. Diabetes Care. 41(10):2202–2211. https://doi.org/10.2337/dc18-0707

    Article  CAS  PubMed  Google Scholar 

  33. Chen X, Rong SS, Xu Q, Tang FY, Liu Y, Gu H et al (2014) Diabetes mellitus and risk of age-related macular degeneration: a systematic review and meta-analysis. PLoS One 9(9):e108196. https://doi.org/10.1371/journal.pone.0108196

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Srinivasan S, Swaminathan G, Kulothungan V, Ganesan S, Sharma T, Raman R (2017) Age-related macular degeneration in a South Indian population, with and without diabetes. Eye (Lond) 31(8):1176–1183. https://doi.org/10.1038/eye.2017.47

    Article  CAS  Google Scholar 

  35. Zhou H, Zhang H, Yu A, Xie J (2018) Association between sunlight exposure and risk of age-related macular degeneration: a meta-analysis. BMC Ophthalmol 18(1):331. https://doi.org/10.1186/s12886-018-1004-y

    Article  PubMed  PubMed Central  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Optretina, Barcelona, Spain

    Miguel A. Zapata

  2. Hospital Vall Hebron, Passeig Roser 126, Sant Cugat del Vallès, 08195, Barcelona, Spain

    Miguel A. Zapata

  3. Optretina Image Reading Team, Barcelona, Spain

    Anniken Burés, Roberto Gallego-Pinazo, Estanislao Gutiérrez-Sánchez, Andrea Oléñik, Salvador Pastor, Jorge Ruiz-Medrano, Cecilia Salinas & Maximino Abraldes

  4. IMO, Instituto de Microcirugía Ocular, Barcelona, Spain

    Anniken Burés & Cecilia Salinas

  5. Oftalvist, Valencia, Spain

    Roberto Gallego-Pinazo

  6. Hospital Universitario Virgen Macarena, Sevilla, Spain

    Estanislao Gutiérrez-Sánchez

  7. Hospital Clínico Universitario, Valladolid, Spain

    Salvador Pastor

  8. Hospital Puerta de Hierro, Madrid, Spain

    Jorge Ruiz-Medrano

  9. Servicio de Medicina preventiva y epidemiología, Hospital Vall Hebron, Barcelona, Spain

    Susana Otero-Romero

  10. Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain

    Maximino Abraldes

Authors
  1. Miguel A. Zapata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anniken Burés
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberto Gallego-Pinazo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Estanislao Gutiérrez-Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andrea Oléñik
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Salvador Pastor
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jorge Ruiz-Medrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cecilia Salinas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Susana Otero-Romero
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Maximino Abraldes
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

On behalf Optretina reading group

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.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Figure S1.

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

High resolution image (TIF 537 kb)

Table S1

(DOCX 14 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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 259, 1993–2003 (2021). https://doi.org/10.1007/s00417-021-05093-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-021-05093-4

Keywords

Search

Navigation