Prevalence of age-related macular degeneration in the United States: a medicare-based analysis from 2014 to 2021

Introduction: Age-related macular degeneration (AMD) is a leading cause of vision loss among older adults in the USA. Understanding its prevalence and demographic distribution is critical for developing targeted public health strategies. This study aimed to assess the prevalence of AMD and its clinical stages among US Medicare beneficiaries aged 65 years and older. Methods: We conducted a retrospective cohort study using the Vision and Eye Health Surveillance System (VEHSS) database of Medicare beneficiaries diagnosed with AMD between 2014 and 2021. Crude prevalence rates for overall AMD, early AMD, intermediate AMD, wet AMD, and geographic atrophy (GA) were calculated at national and state levels. Prevalence was stratified by age, sex, and race/ethnicity. Statistical analyses included the Mann-Whitney U test for age and sex comparisons, the Brown-Forsythe one-way ANOVA for racial/ethnic comparisons, and the Dunnett T3 test for post hoc analyses. Results: In 2021, the VEHSS-Medicare dataset included 24,129,807 individuals aged 65 and older, among whom the national prevalence of AMD was 10.40%. Prevalence rates for early AMD, intermediate AMD, wet AMD, and GA were 2.87%, 6.91%, 2.14%, and 0.73%, respectively. The number of AMD cases increased from 2.33 million in 2014 to 2.51 million in 2021. Prevalence was significantly higher in individuals aged ≥85 years compared to those aged 65-84 years, and in females compared to males. Post hoc analyses demonstrated that White individuals had a significantly higher prevalence of AMD compared with all other racial/ethnic groups. Conclusions: The prevalence of AMD among US adults aged 65 years and older was 10.4%, with higher rates observed in the oldest age groups, females, and White individuals. These findings highlight the importance of addressing disparities in AMD prevention and care, particularly in populations at greatest risk.