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The Potential Impact of New Treatments

David B. Rein, PhD; John S. Wittenborn, BS; Xinzhi Zhang, MD, PhD; Amanda A. Honeycutt, PhD; Sarah B. Lesesne, BS; Jinan Saaddine, MD, MPH; for the Vision Health Cost-Effectiveness Study Group

Arch Ophthalmol. 2009;127(4):533-540.

Objective  To forecast age-related macular degeneration (AMD) and its consequences in the United States through the year 2050 with different treatment scenarios.

Methods  We simulated cases of early AMD, choroidal neovascularization (CNV), geographic atrophy (GA), and AMD-attributable visual impairment and blindness with 5 universal treatment scenarios: (1) no treatment; (2) focal laser and photodynamic therapy (PDT) for CNV; (3) vitamin prophylaxis at early-AMD incidence with focal laser/PDT for CNV; (4) no vitamin prophylaxis followed by focal laser treatment for extra and juxtafoveal CNV and anti–vascular endothelial growth factor treatment; and (5) vitamin prophylaxis at early-AMD incidence followed by CNV treatment, as in scenario 4.

Results  Cases of early AMD increased from 9.1 million in 2010 to 17.8 million in 2050 across all scenarios. In non–vitamin-receiving scenarios, cases of CNV and GA increased from 1.7 million in 2010 to 3.8 million in 2050 (25% lower in vitamin-receiving scenarios). Cases of visual impairment and blindness increased from 620 000 in 2010 to 1.6 million in 2050 when given no treatment and were 2.4%, 22.0%, 16.9%, and 34.5% lower in scenarios 2, 3, 4, and 5, respectively.

Conclusion  Prevalence of AMD will increase substantially by 2050, but the use of new therapies can mitigate its effects.

Author Affiliations: Research Triangle Institute (RTI) International, Research Triangle Park, North Carolina (Drs Rein, Zhang, and Honeycutt, Mr Wittenborn, and Ms Lesesne); Centers for Disease Control and Prevention, National Center For Chronic Disease and Prevention (Drs Zhang and Saaddine).

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