title: Certifications for sight impairment due to age related macular degeneration in England.
abstract: OBJECTIVE
  To examine variability across England in certification rates for age related macular degeneration (AMD) between 1st April 2011 and 31st March 2012.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  An electronic version of the CVI, the ECVI, was used at the Certifications Office, London, to transfer information from paper based certificates into a database. The electronic certifications data set was queried for all certificates completed in England between April 1st 2011 and March 31st 2012 with the main cause of certifiable visual loss being AMD or with the main cause of certifiable visual loss being multiple pathology but a contributory cause being AMD. Data were explored by type of AMD, visual status, age and sex and then directly standardized rates were computed by English region.
  
  
  RESULTS
  The Certifications Office received 23,616 CVIs for England between April 2011 and March 2012, of which 10,481 (44%) were people certified severely sight-impaired (blind) (SSI) and 12,689 (54%) were certified as sight-impaired (partial sight) (SI). The remainder did not have visual status classified. AMD contributed to 11546 causes of certification on the CVI forms during this period, 53% of forms being for geographic atrophy (GA)/dry AMD which is currently mostly untreatable. The median (interquartile) age at certification for AMD was 86 (81, 90) years and women were more commonly certified than men (66%). Considerable variability was seen across English regions, although there was consistency in that GA was the more common form in all areas.
  
  
  CONCLUSIONS
  There is considerable regional variability in CVI rates in England, which are not attributable to differences in age or sex. Reasons for such variability need examination yet this should not undermine the value of these data in terms of describing those newly registered with sight impairment due to AMD who are predominantly female and over 85 years of age.
authors: NIHR Moorfields Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK. Electronic address: c.bunce@ucl.ac.uk.
authors: C
authors: C
authors: Bunce
authors: NIHR Moorfields Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK.
authors: A
authors: A
authors: Zekite
authors: Knowledge and Intelligence Team (West Midlands) Public Health England, UK.
authors: S
authors: S
authors: Walton
authors: NIHR Moorfields Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK.
authors: A
authors: A
authors: Rees
authors: NIHR Moorfields Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK.
authors: P J
authors: PJ
authors: Patel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology*; D002568:Certification / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004739:England; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male
keywords: Age related macular degeneration; Blind; Certification; Partial sight; Severely sight impaired; Sight impairment