Prevalence and causes of registered blindness in the largest federal state of Germany
Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127 Bonn, Germany. The British journal of ophthalmology
(Impact Factor: 2.98).
03/2011; 95(8):1061-7. DOI: 10.1136/bjo.2010.194712
As no current estimates for the prevalence and causes of blindness in Germany are available, the database of Germany's largest welfare institution (covering 9.5 million people in the federal state of Northrhine) assessing eligibility for an allowance payable to blind people was used to investigate the prevalence and the specific causes of blindness and visual impairment.
Data from a representative sample of 5100 cases out of 20 365 cases were extracted, entered into an electronic database and statistically analysed. Blindness and severe vision impairment were defined as visual acuity equal to or below 20/1000 and 20/400, respectively, in the better-seeing eye.
The mean age of the overall sample was 72±22 years and the mean visual acuity of the better seeing eye was 20/800. The prevalence of blindness and severe vision impairment in Northrhine was estimated to be 47.91 per 25,000 [corrected] persons. Most registered visual impairment was due to age-related macular degeneration (AMD; 41%), followed by glaucoma (15%) and diabetic eye disease (10%). Sixty-five per cent of registered blind people were women, 56% of them over the age of 80 years. Registered children and teenagers had the relative worst visual acuity (hand movement) and patients with retinal dystrophies had the relative best visual acuity (20/200) within the whole cohort (p<0.001). Standardised prevalence of blindness and severe visual impairment for Germany is estimated to be 44.4/100.000 (57.94 for women and 30.78 for men).
Prevalence of blindness and severe vision impairment for Germany compare well to other European countries. AMD is the most prevalent cause of registered blindness and severe vision impairment, and prevalence in women is higher. Generally, prevalence increases with age. Provision of support and welfare services need to be organised accordingly.
Available from: Heidi A Baseler
- "According to the World Health Organization, in 2002, age-related macular degeneration (AMD) and juvenile macular degeneration (JMD) were the causes of blindness and low-vision in 8.7% of the 160 million cases worldwide (Resnikoff et al., 2004). In recent reports, AMD prevalence ranged from approximately 3e12% (Cheung et al., 2012; Finger et al., 2011; Jenchitr et al., 2011; Jonasson et al., 2011; Klein et al., 2011; Nangia et al., 2011; Ngai et al., 2011; Spanish Eyes Epidemiological Study Group, 2011; Stein et al., 2011; Yoon et al., 2011), while the prevalence of JMD was .03% (Pi et al., 2012). "
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Macular degeneration (MD) causes central visual field loss. When field defects occur in both eyes and overlap, parts of the visual pathways are no longer stimulated. Previous reports have shown that this affects the grey matter of the primary visual cortex, but possible effects on the preceding visual pathway structures have not been fully established.
In this multicentre study, we used high-resolution anatomical magnetic resonance imaging and voxel-based morphometry to investigate the visual pathway structures up to the primary visual cortex of patients with age-related macular degeneration (AMD) and juvenile macular degeneration (JMD).
Compared to age-matched healthy controls, in patients with JMD we found volumetric reductions in the optic nerves, the chiasm, the lateral geniculate bodies, the optic radiations and the visual cortex. In patients with AMD we found volumetric reductions in the lateral geniculate bodies, the optic radiations and the visual cortex. An unexpected finding was that AMD, but not JMD, was associated with a reduction in frontal white matter volume.
MD is associated with degeneration of structures along the visual pathways. A reduction in frontal white matter volume only present in the AMD patients may constitute a neural correlate of previously reported association between AMD and mild cognitive impairment.
Cortex 01/2013; 56. DOI:10.1016/j.cortex.2013.01.003 · 5.13 Impact Factor
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ABSTRACT: To determine the prevalence of blinding eye disease in Western Australia using a capture and recapture methodology.
Three independent lists of residents of Western Australia who were also legally blind were collated during the capture periods in 2008-9. The first list was obtained from the state-wide blind register. A second list comprised patients routinely attending hospital outpatient eye clinics over a 6-month period in 2008. The third list was patients attending ophthalmologists' routine clinical appointments over a 6-week period in 2009. Lists were compared to identify those individuals who were captured on each list and those who were recaptured by subsequent lists. Log-linear models were used to calculate the best fit and estimate the prevalence of blindness in the Western Australian population and extrapolated to a national prevalence of blindness in Australia.
1771 legally blind people were identified on three separate lists. The best estimate of the prevalence of blindness in Western Australia was 3384 (95% CI 2947 to 3983) or 0.15% of the population of 2.25 million. Extrapolating to the national population (21.87 million) gave a prevalence of legal blindness of approximately 32,892 or 0.15%.
Capture-recapture techniques can be used to determine the prevalence of blindness in whole populations. The calculated prevalence of blindness suggested that up to 30% of legally blind people may not be receiving available financial support and up to 60% were not accessing rehabilitation services.
The British journal of ophthalmology 11/2011; 96(4):478-81. DOI:10.1136/bjophthalmol-2011-300908 · 2.98 Impact Factor
Der Ophthalmologe 02/2012; 109(2):110-1. DOI:10.1007/s00347-011-2451-5 · 0.50 Impact Factor
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