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      Expert Consensus on Geographic Atrophy in the EU: A Call for Urgent Policy Action

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          Abstract

          Geographic atrophy is an eye disease that greatly interferes with the daily lives of patients and their families, posing a serious threat to the aging European demographic. Over the past 30 months, this initiative has assembled leading experts in the field of ophthalmology to share insights on the necessary policy steps that need to be taken to overcome this challenge on an EU-wide scale. Through analyzing best practices in Germany, Italy, France, and Spain, this consensus paper sets out a series of policy recommendations, which, if implemented, could greatly benefit all individuals affected by geographic atrophy. Amongst other features, these countries have provided valuable examples of awareness campaigns and an overall commitment to inclusive and comprehensive policies. The policy recommendations emerging from this paper include the adoption of comprehensive screening programs, retinal disease screening in the EU Driving License Directive, the development of a white paper at the European Commission, and the creation of Council recommendations on eye health screening. Given the significant improvements made at the national level throughout the EU, countries will require unitary support at the European level to further develop their policies and successfully address the burden of geographic atrophy.

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          Incidence of Late-Stage Age-Related Macular Degeneration in American Whites: Systematic Review and Meta-analysis.

          To estimate incidence of age-related macular degeneration (AMD) by subtype in American whites aged ≥50 years.
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            Age-Related Macular Degeneration

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              Age and gender variations in age-related macular degeneration prevalence in populations of European ancestry: a meta-analysis.

              To obtain prevalence estimates of age-related macular degeneration (AMD; late, geographic atrophy, neovascular) by age and gender amongst populations of European ancestry taking into account study design and time trends. Systematic review of population-based studies published by September 2010 with quantitative estimates of geographic atrophy (GA), neovascular (NV), and late AMD prevalence. Studies were identified by a literature search of MEDLINE (from 1950), EMBASE (from 1980), and Web of Science (from 1980) databases. Data from 25 published studies (57 173 subjects: 455 with GA, 464 with NVAMD, and 1571 with late AMD). Bayesian meta-regression of the log odds of AMD with age, gender, and year of study allowing for differences in study design characteristics, to estimate prevalences of AMD (late, GA, NVAMD) along with 95% credible intervals (CrI). Log odds and prevalence of AMD. There was considerable heterogeneity in prevalence rates between studies; for late AMD, 20% of the variability in prevalence rates was explained by differences in age and 50% by study characteristics. The prevalence of AMD increased exponentially with age (odds ratio [OR], 4.2 per decade; 95% CrI, 3.8-4.6), which did not differ by gender. There was some evidence to suggest higher risk of NVAMD in women compared with men (OR, 1.2; 95% CrI, 1.0-1.5). Compared with studies using fundus imaging and international classification systems, studies using fundus imaging with alternative classifications were more likely (OR, 2.7; 95% CrI, 1.1-2.8), and studies using alternative classifications without fundus imaging most likely to diagnose late AMD (OR, 2.9; 95% CrI, 1.3-7.8). There was no good evidence of trends in AMD prevalence over time. Estimated prevalence of late AMD is 1.4% (95% CrI, 1.0%-2.0%) at 70 years of age, rising to 5.6% (95% CrI, 3.9%-7.7%) at age 80 and 20% (95% CrI, 14%-27%) at age 90. Studies using recognized classifications systems with fundus photography reported the lowest prevalences of AMD taking account of age and gender, and were stable over time, with a potentially higher risk of NVAMD for women. These prevalence estimates can be used to guide health service provision in populations of European ancestry. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                giuseppe.querques@hotmail.it
                Journal
                Ophthalmol Ther
                Ophthalmol Ther
                Ophthalmology and Therapy
                Springer Healthcare (Cheshire )
                2193-8245
                2193-6528
                22 February 2024
                22 February 2024
                April 2024
                : 13
                : 4
                : 867-881
                Affiliations
                [1 ]IRCCS Ospedale San Raffaele Milan, ( https://ror.org/039zxt351) Milan, Italy
                [2 ]Medical Retina and Imaging Unit, Department of Ophthalmology, University Vita-Salute San Raffaele Milan, ( https://ror.org/01gmqr298) Milan, Italy
                [3 ]Association DMLA (Dégénérescence Maculaire Liée À L’Age), Paris, France
                [4 ]Retina Italia, Milan, Italy
                [5 ]Retina International, PRO RETINA Germany, Amberg, Germany
                [6 ]GRID grid.18887.3e, ISNI 0000000417581884, Department of Ophthalmology, , Vita-Salute University, San Raffaele Scientific Institute, Associazione Pazienti Retina, ; Milan, Italy
                [7 ]Department of Ophthalmology, University of Bonn, ( https://ror.org/041nas322) Bonn, Germany
                [8 ]GRID grid.42399.35, ISNI 0000 0004 0593 7118, University Hospital of Bordeaux, ; Bordeaux, France
                [9 ]Associazione Comitato Macula, Genoa, Italy
                [10 ]Asociación Acción Visión España, Oviedo, Spain
                [11 ]GRID grid.73221.35, ISNI 0000 0004 1767 8416, Puerta de Hierro University Hospital, ; Madrid, Spain
                [12 ]UCLM University, Madrid, Spain
                [13 ]University Hospital Hamburg-Eppendorf, ( https://ror.org/03wjwyj98) Hamburg, Germany
                Author information
                http://orcid.org/0000-0002-3292-9581
                Article
                899
                10.1007/s40123-024-00899-x
                10912394
                38386187
                d8c3576f-5f53-4edb-99c0-d809b416e5ce
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 15 January 2024
                : 25 January 2024
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                © Springer Healthcare Ltd., part of Springer Nature 2024

                europe,geographic atrophy,retina,screening
                europe, geographic atrophy, retina, screening

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