Prevalence of Age-Related Macular Degeneration (AMD)
The VEHSS Composite Prevalence Estimates for Age-Related Macular Degeneration (AMD) are the primary surveillance outcomes reported by VEHSS for AMD. Statistical modeling methods are used to combine information from multiple data sources available in VEHSS to produce estimates of the total prevalence of AMD at the national, state, and county level.
The Vision and Eye Health Surveillance System (VEHSS) reports the prevalence of AMD for the following categories based on the method of identification:
- VEHSS Composite Prevalence Estimate: Age-Related Macular Degeneration
- Examination-based AMD
- Self-reported AMD
- Diagnosed AMD
VEHSS Composite Prevalence Estimate: Age-Related Macular Degeneration
The Vision and Eye Health Surveillance System (VEHSS) composite prevalence estimate of AMD is CDC’s primary estimate of the prevalence of AMD in the United States. These composite estimates are generated by combining multiple sources of data available in VEHSS, including National Health and Nutrition Examination Survey (NHANES) graded retinal images, abstracted data from published examination studies, Medicare claims, and American Community Survey (ACS) national, state and county population estimates.
- Vision Threatening AMD: Also referred to as “Late Stage AMD,” includes vision threatening advanced stages of AMD including geographic atrophy and/or exudative AMD (alternatively defined as wet-form AMD or choroidal neovascularization) in either eye.
- Non-Vision Threatening AMD: Also referred to as “Early Stage AMD,” includes retinal pigment epithelium abnormalities or drusen ≥125 µm in the worse-affected eye, but no vision threatening AMD in either eye.
| Subgroup | Indicated conditions |
|---|---|
| Vision Threatening AMD |
Includes vision threatening advanced stages of AMD including geographic atrophy and/or exudative AMD (alternatively defined as wet-form AMD or choroidal neovascularization) in either eye. Also referred to as “Late Stage AMD”. |
| Non-Vision Threatening AMD |
Includes retinal pigment epithelium abnormalities or drusen ≥125 µm in the worse-affected eye, but no vision threatening AMD in either eye. Also referred to as “Early Stage AMD”. |
Explore the VEHSS Composite Estimates. See the Composite Prevalence Estimates summary page for more information and highlighted results.
Examination-Based AMD
The National Health and Nutrition Examination Survey (NHANES) included identification of AMD based on retinal images. VEHSS summarizes the NHANES results, which represent a population-level prevalence estimate of AMD. VEHSS also includes summaries of published estimates of AMD prevalence from population-based studies.
| Dataset | Description | Variable name(s) | Sample | Response options |
|---|---|---|---|---|
| NHANES | Percentage of people with age-related macular degeneration, based on examination | Opduarm – ARM, 3 severity levels, worse eye | Ages 40-150 | No, Yes, Missing |
The data sources available for this category include NHANES and Literature Review. See data source documentation.
Self-Reported AMD
The National Health Interview Survey (NHIS) and NHANES include self-report questions on whether a doctor ever told the respondent that they had AMD. VEHSS summarizes the prevalence of self-reported diagnosed AMD, which represents indicators of population prevalence of previously diagnosed AMD.
| Dataset | Description | Question Text | Variable name(s) | Sample | Response options |
|---|---|---|---|---|---|
| NHANES | Percentage of people who were ever told by an eye doctor they have age-related macular degeneration | {Have you/Has SP} ever been told by an eye doctor that {you have/s/he has} age-related macular (mac-u-lar) degeneration? | VIQ310 | Ages 40 -15 | Yes, No, Refused, Don’t know |
| NHIS | Percentage of adults ever told by a doctor or other health professional they had macular degeneration | Have you EVER been told by a doctor or other health professional that you had macular degeneration | VIM_MDEV | Ages 18+ | Yes, No, Refused, Not ascertained, Don’t know |
Explore Data in the VEHSS Application
The data sources available for this category include NHANES and NHIS (Adult Module). See data source documentation.
Diagnosed age-related macular degeneration (AMD) is identified based on the presence of International Classification of Diseases (ICD)-9 and ICD-10 codes in patient claims or electronic health record (EHR) systems. Patients with one or more diagnosis codes associated with a VEHSS subgroup are assigned to that subgroup. Diagnosis codes may be primary or secondary. Only one instance of a diagnosis code is required for assignment to the subgroup. Note that diagnosis codes in claims data are intended for billing purposes. Codes may not be present in cases where diagnosis codes are not required to justify payment. Diagnosed prevalence will also not identify any undiagnosed conditions, will not include patients not covered by the insurer, and will not identify prevalence among patients without a visit in the calendar year of data.
AMD, Clinical Subgroups
VEHSS defines the following clinical subgroups. Clinical subgroups are not mutually exclusive.
| Subgroup | Indicated conditions |
|---|---|
| Diagnosed AMD – any stage | Category total – includes any clinical stage below. |
| AMD, unspecified | Unspecified AMD includes diagnosis codes indicating degeneration of macula and/or posterior pole but does not specify stage. |
| Early AMD | Early AMD includes diagnosis codes indicating the presence of drusen (degenerative) of the macula, an early manifestation of dry-form AMD. |
| Dry-form AMD | Dry-form AMD includes diagnosis codes indicating nonexudative age-related macular degeneration. |
| Geographic atrophy AMD | Geographic atrophy AMD includes ICD-10 codes approved after October 2018 indicating the advanced atrophic stage of dry-form AMD. Because this is a new code, geographic atrophy is included in VEHSS as a subgroup of dry-form AMD. |
| Wet-form AMD | Wet-form AMD includes diagnosis codes indicating exudative age-related macular degeneration. |
| Choroidal neovascularization AMD | Choroidal neovascularization AMD includes ICD-10 codes approved after October 2018 specifying active choroidal neovascularization (advanced wet-form AMD). Because this is a new code, choroidal neovascularization AMD is included in VEHSS as a subgroup of wet-form AMD. |
Explore Data in the VEHSS Application
The data sources available for this category include NHANES and NHIS (Adult Module). See data source documentation.
Full list of ICD-9 and ICD-10 codes.
AMD by Vision-Threatening Status
VEHSS defines the following summary subgroups indicating vision-threatening AMD. These summary groups are mutually exclusive and sum to equal the category total of all patients with diagnosed AMD of any stage.
| Subgroup | Indicated conditions |
|---|---|
| Vision-threatening AMD | Geographic atrophy, wet-form AMD, or choroidal neovascularization |
| Non vision-threatening AMD | Unspecified AMD, early AMD, or dry-form AMD AND NOT vision-threatening AMD |
Explore Data in the VEHSS Application
The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims. See data source documentation.