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Potential to improve the burden of age-related macular degeneration: results from the Global Burden of Disease Study 2021

Eye volume 39, pages 2064–2072 (2025)Cite this article

Subjects

Abstract

Background

Age-related macular degeneration (AMD) is a critical public health issue, requiring prioritized public health strategies.

Methods

Based on the Global Burden of Disease Study 2021, AMD burden and risk factors were analyzed, considering variables such as sex, age, and ___location. Age-standardized rates (ASR) were employed to evaluate and compare the burdens across different regions. Frontier analysis was used to determine the lowest achievable burden based on the Sociodemographic Index (SDI), while decomposition analysis revealed factors influencing age-related macular degeneration burden change.

Results

Globally, in 2021, ASR of prevalence and disability-adjusted life years (DALYs) were 94.00 (95% UI 78.32, 114.42) per 100,000 and 6.78 (95% UI 4.70, 9.32) per 100,000 respectively. Additionally, a reduction of smoking exposure to its theoretical minimum risk exposure level (TMREL) would lead to an estimated 10.0% decrease in AMD DALYs in 2021. Frontier analysis suggested that Nepal, Iran (Islamic Republic of), and Nigeria were the top three countries with the most substantial potential for reducing disparities. Decomposition analysis indicated that population growth and aging are the primary driving factors for the increase in AMD DALYs.

Conclusions

We identify countries and territories with potential for improvement and emphasize the importance of equitable, cost-effective control strategies, particularly tobacco control.

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Fig. 1: Changes of age-standardized rates (ASR) of prevalence and disability-adjusted life years (DALYs) from 1990 to 2021.
Fig. 2: Numbers and age-standardized rates (per 100,000 population) of prevalence from AMD at the global and region levels by age group and sex, 2021.
Fig. 3: Frontier analysis based on Sociodemographic Index (SDI) and age-standardized AMD prevalence and disability-adjusted life year (DALY) rates, 1990–2021.
Fig. 4: Change in disability-adjusted life years (DALYs) at the global and Sociodemographic Index (SDI) region levels, 1990–2021, due to population growth, population aging, trends in exposure to all risks, and all other (risk-deleted or residual) factors.
Fig. 5

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Data availability

The dataset analyzed during the current study are available in the Institute for Health Metrics and Evaluation (IHME): http://ghdx.healthdata.org/gbd-results-tool.

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Acknowledgements

Thanks to the Institute for Health Metrics and Evaluation, the World Health Organization, the World Bank, and the International Labor Organization for making data public.

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Authors and Affiliations

  1. General Practice Department, Aerospace Center Hospital, Beijing, PR China

    Zhongming Zhang, Xiaojing Zhang, Ran Zhang, Chaonan Tan, Jinyue Bai, Panpan Zhang, Siyi Yang & Yun Gao

  2. Department of Ophthalmology, Aerospace Center Hospital, Beijing, PR China

    Yu Ling

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Contributions

ZZ conceptualized the study, curated and analyzed data, developed methodology and software, validated results, visualized findings, and drafted and revised the manuscript. XZ conducted formal analysis, implemented software, and created visualizations. RZ contributed to study conceptualization and critically reviewed/edited the manuscript. CT visualized data, wrote the initial draft, and revised the manuscript. JB validated results, curated data, and created visualizations. PZ curated data, contributed to methodology development, and visualized findings. SY conceptualized the study and validated results. YG oversaw conceptualization, administered the project, supervised research activities, and validated outcomes. All authors approved the final version for publication and agree to accountability for all aspects of the work.

Corresponding authors

Correspondence to Yu Ling or Yun Gao.

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The authors declare no competing interests.

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The study has been evaluated by the Ethics Committee of the Aerospace Center Hospital and deemed not to require ethics approval.

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Zhang, Z., Zhang, X., Zhang, R. et al. Potential to improve the burden of age-related macular degeneration: results from the Global Burden of Disease Study 2021. Eye 39, 2064–2072 (2025). https://doi.org/10.1038/s41433-025-03786-2

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