title: Prevalence and incidence of blindness and other degrees of sight impairment in patients treated for neovascular age-related macular degeneration in a well-defined region of the United Kingdom.
abstract: OBJECTIVE
  This study aimed to evaluate the incidence and prevalence of blindness, sight impairment, and other visual acuity (VA) states in patients receiving ranibizumab for neovascular age-related macular degeneration (nAMD) in Gloucestershire.
  
  
  METHODS
  Serial VA and injection data for all treatment-naive patients receiving their first intravitreal injections of ranibizumab for nAMD in the Gloucestershire National Health Service Ophthalmology department between 2008 and 2010 were extracted from an electronic medical record system.
  
  
  RESULTS
  The prevalence of blindness (VA in the better-seeing eye ≤25 Early Treatment Diabetic Retinopathy Study (ETDRS) letters) at the time of first intravitreal injection was 0.8%, increasing to 3.5% after 3 years. The prevalence of sight impairment (VA in the better-seeing eye 26-39 ETDRS letters) increased from 4.1% at baseline to 5.5% after 3 years. The incidence of initiating ranibizumab treatment for nAMD in people aged ≥50 years in Gloucestershire was 111 people per 100 000 population in 2009, and 97 people in 2010. The incidence of patients meeting the visual criteria for blindness and sight impairment registration from treated nAMD in people aged ≥50 years in Gloucestershire was 3.5 and 9.7 people, respectively per 100 000 population in 2010.
  
  
  CONCLUSIONS
  This is the first real-world study on the incidence and prevalence of eligibility for blindness and sight impairment registration in treated nAMD in the UK based on VA data. The incidence and prevalence of eligibility for certification of blindness or sight impairment in patients treated with ranibizumab for nAMD is low in Gloucestershire, with only 3.6% of the incident population progressing to blindness in 2010.
authors.affiliation: Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham Hospital, Cheltenham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Buckle
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham Hospital, Cheltenham, UK.
authors.forename: Q
authors.initials: Q
authors.lastname: Mohamed
authors.affiliation: Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham Hospital, Cheltenham, UK.
authors.forename: E
authors.initials: E
authors.lastname: Fletcher
authors.affiliation: Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham Hospital, Cheltenham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sallam
authors.affiliation: Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham Hospital, Cheltenham, UK.
authors.forename: R
authors.initials: R
authors.lastname: Healy
authors.affiliation: Gloucester Diabetic Retinopathy Research Group, Cheltenham General Hospital, Cheltenham, UK.
authors.forename: I
authors.initials: I
authors.lastname: Stratton
authors.affiliation: Medical Retina Department, Moorfields Eye Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tufail
authors.affiliation: Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham Hospital, Cheltenham, UK.
authors.forename: R L
authors.initials: RL
authors.lastname: Johnston
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001766:Blindness / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D000069579:Ranibizumab; D012042:Registries; D006113:United Kingdom / Q000453:epidemiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D015354:Vision, Low / Q000453:epidemiology*; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab