Prevalence and Health Care Disparities of Retinal Conditions: A Meta-Analysis

Age-related macular degeneration (AMD), diabetic retinopathy (DR), diabetic macular edema (DME), and retinal vein occlusion (RVO) are leading causes of vision impairment and can lead to permanent, irreversible blindness.

To update age-standardized prevalence estimates for AMD, DR, DME, and RVO by gender, race and ethnicity, and US state or county for 2022.

The National Health and Nutrition Examination Survey (NHANES; 2005-2008 and 2017-March 2020), Medicare fee-for-service claims (2017-2019), IBM MarketScan commercial insurance claims (2016), and eligible population-based studies.

Bayesian meta-regression analysis of data sources containing prevalence information for AMD, DR, DME, and RVO in the US. Data were analyzed from March to September 2024.

AMD prevalence was estimated for ages 40 years and older and reported as total AMD (inclusive of early and late stage). DR (stratified by vision threatening and non-vision threatening) and DME prevalence were estimated across all ages as a proportion of people with diabetes (as defined in NHANES). RVO, defined by the presence of either retinal branch or central vein occlusion, was estimated for ages 18 years and older. Age-standardized estimates were calculated using the 2010 US Census age pyramid.

For 2022, age-standardized prevalence estimates per 100 000 people were 5677 (95% uncertainty interval [UI], 4513-7374) for AMD, 2710 (95% UI, 2112-3647) for DR, 317 (95% UI, 243-505) for DME, and 214 (95% UI, 168-409) for RVO. For all conditions, prevalence was higher in males than females. White individuals had 1.7-fold higher AMD prevalence than Black individuals and 2-fold higher RVO prevalence than Hispanic individuals; Black individuals had more than 2-fold higher DR prevalence and 4.6-fold higher DME prevalence than White individuals, and Hispanic individuals had 1.8-fold higher DR prevalence and 3.7-fold higher DME prevalence than White individuals. State-level prevalence (per 100 000 people) ranged from 3497 to 7214 for AMD, 1654 to 3607 for DR, 126 to 504 for DME, and 157 to 273 for RVO.

In this meta-analysis, the US prevalence of retinal conditions was substantial, highlighting a considerable health care burden. The updated estimates and sex, race and ethnicity, and regional disparities identified in this study could inform resource allocation across the US and aid in the development of approaches to improve treatment accessibility and patient outcomes for underserved communities.