Whitebook on disease

Europe is facing intense demographic changes due to population ageing and a subsequent increase in age-related eye diseases. An increase in visual impairment and blindness in older Europeans due to retinal diseases is expected in the years to come. To date, there has been a lack of comprehensive data on the current situation as well as future projections of retinal diseases in Europe. EURETINA has funded and now published a whitebook on retinal diseases in Europe, which provides reliable figures and the bigger picture for the development of prevention and intervention strategies. Most common retinal diseases are age-related diseases, which leads to the expectation of increased numbers of affected individuals in Europe in the future. Therefore, there will be major challenges for European ophthalmology facing an ageing population. Two of the main causes for blindness and severe vision loss in Europe are retinal diseases: age-related macular degeneration (AMD) and diabetic eye disease (DED). The lack of comprehensive data on the prevalence and incidence of retinal diseases has been the starting point to fund a systematic literature review and meta-analysis of relevant sources and an analysis of implications to come up with the most up-to-date figures on prevalence and incidence as well as forecasts. All available data on the main retinal diseases were collated in the European Union (EU) as well as its five largest countries: Germany, the United Kingdom, France, Italy and Spain. The information in the whitebook will inform all stakeholders and identifies current and future challenges that need to be addressed appropriately. In order to avoid an increasing number of blind and severely visually impaired Europeans in the decades to come, health services and research efforts need to be planned accordingly now. OBVIOUS IMPLICATIONS The data shows that one-in-four Europeans over the age of 60 is affected by AMD. The highest prevalence of any AMD was found in Italy, followed by France and Germany. The total number of EU inhabitants affected by AMD was estimated at 34 million. Late AMD occurs newly in 1.4 per 1,000 individuals each year. The prevalence of AMD is about to rise by 20% until 2050. With regard to anti-VEGF therapy, there are obvious implications for logistical challenges in the coverage for this mode of therapy, with repetitive intravitreal injections over a long period of time. Likewise, the numbers of patients affected by DED are on the rise, with an estimate of 3.8 million affected in 2040. In addition, barriers to screening and management of DEDs must be addressed. The work presented in the whitebook was conducted over 18 months at the Department of Ophthalmology and the Department of Medical Biometry, Informatics and Epidemiology, University of Bonn, Germany. “Considerable healthcare resources will be needed to maintain vision in Europeans," said Prof Dr Frank G Holz, chair of the Department of Ophthalmology in Bonn and EURETINA President Elect. Prof Jan van Meurs, President of EURETINA, said that against the background of an ageing European population and the increasing prevalence of retinal disease improvements are necessary both in current and future service provisions, as well as in research. “The numbers in the whitebook would demand that research resources need to be identified to develop more efficacious treatment as well as faster translation of evidence into practice when novel diagnostic, preventive or therapeutic intervention has become available, which would also include an acceleration of the regulatory review processes as well as access to funding,” concluded Prof Dr Robert Finger, senior author of the whitebook, epidemiologist and clinician from Bonn. The whitebook is available online at euretina.org. Frank Holz: frank.holz@ukb.uni-bonn.de