Global Burden of Age-Related Macular Degeneration: Trends, Regional Disparities, and Projections From the Global Burden of Disease Study 2021 Publisher Pubmed



Azizmohammad Looha M ; Amanollahi M ; Hashemi E ; Jameie M ; Mohammadpoor A ; Mozafar M ; Samiee R ; Jalalinejad M ; Arevalo JF
Source: Graefe's Archive for Clinical and Experimental Ophthalmology Published:2026

Abstract

Purpose: Age-related macular degeneration (AMD) is one of the major causes of visual loss globally. This study assessed the global, regional, and national burden of AMD between 1990 and 2021 based on data from the Global Burden of Disease (GBD) study. Methods: AMD burden was evaluated using two outcomes, the age-standardized prevalence rate (ASPR) and the age-standardized years lived with disability rate (ASYR), both expressed per 100,000 population. Data from 204 countries and territories were analyzed and aggregated into 21 regions and 7 super-regions based on the GBD 2021 dataset. Temporal trends were evaluated using joinpoint regression, future estimates were forecasted using autoregressive integrated moving average models, and development-related inequalities were examined using multilevel modeling. Geographic clustering of AMD burden was determined through spatial analysis. Results: In 2021, the global ASPR of AMD was 94.0 per 100,000 population, and the global ASYR was 6.78 per 100,000 population. Between 1990 and 2021, there was a consistent global reduction, with an AAPC of − 0.15 (95% CI: − 0.19 to − 0.12) for ASPR and − 0.69 (95% CI: − 0.71 to − 0.67) for ASYR. The declines were steepest in South Asia (AAPC: − 1.05 for ASPR, − 1.50 for ASYR) and High-Income regions (–0.90 and − 1.21, respectively; all p < 0.001). Conversely, Southeast Asia, East Asia, and Oceania experienced no significant change in ASPR (AAPC: 0.01; p = 0.463) and only minimal reduction in ASYR (AAPC: − 0.33; p < 0.001). Throughout all super-regions, females consistently had a higher AMD burden than males. Longitudinal multilevel analysis revealed quicker reductions in ASPR and ASYR of AMD in more developed nations, with significant time-development status interaction effects (– 0.36 for ASPR and − 0.02 for ASYR; both p < 0.001). Spatial analysis revealed AMD hotspots in West Africa, the Middle East, and the Caribbean, with high clustering of both ASPR and ASYR in these areas. Projections suggest that global ASPR and ASYR will remain broadly stable through 2040. Conclusions: While the ASPR and ASYR of AMD have decreased worldwide, there are still regional and sex disparities. Hotspot regions indicate where targeted interventions are warranted. With an aging population, the absolute burden will increase, so early detection and planning are crucial. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.