Abstract
The objectives of this study are to estimate the recent population-based incidences of all-cause and cause-specific blindness in Germany and compare them with results from a similar study conducted in 1994–1998. All blindness allowance recipients newly registered between January 2008 and December 2009 in a region in southern Germany (population, approximately 3.5 million) were assessed and their ophthalmological reports reviewed. The main causes of blindness were identified and their incidences estimated. There were 572 newly registered cases of blindness allowance. The all-cause incidence of blindness (per 100,000 person-years) in the general population was 8.4 (95 % confidence interval, 7.8–9.2), and the highest incidences were for macular degeneration (3.4; 3.0–3.9), diabetic retinopathy (0.8; 0.6–1.1) and glaucoma (0.7; 0.5–0.9). During the last two decades, blindness incidences decreased for all the main causes (standardised to the West German population 1991: 12.3; 11.9–12.7 in 1994–1998 vs. 7.3; 6.7–8.0 in 2008–2009). The highest absolute decrease was for macular degeneration and the highest relative decrease was for cataract. The most frequent main causes of blindness in Germany remained macular degeneration, diabetic retinopathy and glaucoma. Our findings suggest a remarkable decrease in the incidences of blindness, probably because of new diagnostic options and effective treatments.
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Wu L, Sun X, Zhou X, Weng C. Causes and 3-year incidence of blindness in Jing-An District, Shanghai, China, 2001–2009. BMC Ophthalmol. 2011;11:10.
Avisar R, Friling R, Snir M, Avisar I, Weinberger D. Estimation of prevalence and incidence rates and causes of blindness in Israel, 1998–2003. Isr Med Assoc J. 2006;8:880–1.
The Eye Diseases Prevalence Research Group. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122:477–85.
Krumpaszky HG, Klaus V. Zeittrends bei Erblindungsursache [Time trends of causes of blindness]. Klin Monatsbl Augenheilk. 1997;210:9–16 (German).
Bertram B, Hammers H. Die Prävalenz der Erblindungen wegen diabetischer Retinopathie steigt weiter [The prevalence of loss of eyesight due to diabetic retinopathy continues to rise]. Z Prakt Augenheilkd. 1997;18:181–4 (German).
Bunce C, Wormald R. Leading causes of certification for blindness and partial sight in England & Wales. BMC Public Health. 2006;6:58.
Statistisches Bundesamt. Statistik der Schwerbehinderten Menschen [Statistic of seriously disabled people]. Wiesbaden: Statistisches Bundesamt; 2009 (German). http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Publikationen/Fachveroeffentlichungen/Sozialleistungen/SozialSchwerbehinderte2007pdf,property=file.pdf. Accessed 20 Dec 2011.
Statistisches Bundesamt. Bevölkerung nach dem Gebietsstand [Population according to the area]. Berlin: Statistisches Bundesamt; 2011 (German). http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Statistiken/Zeitreihen/LangeReihen/Bevoelkerung/Content75/lrbev03a,templateId=renderPrint.psml. Accessed 20 Dec 2011.
Ministry of Social Affairs of Baden-Württemberg, personal communication, 2010.
Statistisches Landesamt Baden-Württemberg. Statistische Berichte Baden-Württemberg: Bevölkerung und Erwerbstätigkeit. Artikel-Nr. 3121 11002 [Statistical reports of Baden-Württemberg: population and employment. Article-No. 312 11002]. Stuttgart: Statistisches Landesamt Baden-Württemberg; 2011 (German). http://www.statistik-bw.de/Veroeffentl/Statistische_Berichte/3121_11002.pdf. Accessed 20 Dec 2011.
Finger RP, Fimmers R, Holz FG, Scholl HP. Prevalence and causes of registered blindness in the largest federal state of Germany. Br J Ophthalmol. 2011;95:1061–7.
Bunce C, Xing W, Wormald R. Causes of blind and partial sight certifications in England and Wales: April 2007–March 2008. Eye. 2010;24:1692–9.
Trautner C, Haastert B, Giani G, Berger M. Incidence of blindness in southern Germany between 1990 and 1998. Diabetologia. 2001;44:147–50.
Genz J, Scheer M, Trautner C, Zöllner I, Giani G, Icks A. Reduced incidence of blindness in relation to diabetes mellitus in southern Germany? Diabet Med. 2010;27:1138–43.
Trautner C, Haastert B, Richter B, Berger M, Giani G. Incidence of blindness in southern Germany due to glaucoma and degenerative conditions. Invest Ophthalmol Vis Sci. 2003;44:1031–4.
Trautner C, Icks A, Haastert B, Plum F, Berger M. Incidence of blindness in relation to diabetes: a population-based study. Diabetes Care. 1997;20:1147–53.
Icks A, Trautner C, Haastert B, Berger M, Giani G. Blindness due to diabetes: population-based age- and sex-specific incidence rates. Diabet Med. 1997;14:571–5.
Finger RP, Fimmers R, Holz FG, Scholl HPN. Incidence of blindness and severe visual impairment in Germany—projections for 2030. Invest Ophthalmol Vis Sci. 2011;52:4381–9.
Work Group Epidemiological Methods. Good practice analysis of secondary data: revision after detailed working-over. Gesundheitswesen. 2008;70:54–60 (German).
Wolfram C, Pfeiffer N. Blindness and low vision in Germany 1993–2009. Ophthalmic Epidemiol. 2012;19:3–7.
Pauleikhoff D, Kirchhof B, Bertram B, et al. New aspects in the treatment of neovascular age-related macular degeneration: the criteria of re-treatment with anti-VEGF therapy. Ophthalmologe. 2011;108:85–90 (article in German).
Current position of the Retinological Society, the German Ophthalmology Society and the Professional Union of Ophthalmologists in Germany. New aspects in the management of exudative age-related macular degeneration. Klin Monbl Augenheilkd. 2009;226:388–95 (article in German).
Ip MS, Scott IU, Brown GC, et al. Anti-vascular endothelial growth factor pharmacotherapy for age-related macular degeneration: a report by the American Academy of Ophthalmology. Ophthalmology. 2008;115:1837–46.
Bloch SB, Larsen M, Munch IC. Incidence of legal blindness from age-related macular degeneration in Denmark: year 2000 to 2010. Am J Ophthalmol. 2012;153:209-13.e2.
Lin SC, Singh K, Jampel HD, et al. Optic nerve head and retinal nerve fiber layer analysis: a report by the American Academy of Ophthalmology. Ophthalmology. 2007;114:1937–49. Erratum in Ophthalmology. 2008;115:472.
Hoffmeister L, Román R, Comas M, Cots F, Bernal-Delgado E, Castells X. Time-trend and variations in the proportion of second-eye cataract surgery. BMC Health Serv Res. 2007;7:53.
Skaat A, Chetrit A, Belkin M, Kinori M, Kalter-Leibovici O. Time trends in the incidence and causes of blindness in Israel. Am J Ophthalmol. 2012;153(214–21):e1.
Gunnlaugsdottir E, Arnarsson A, Jonasson F. Five-year incidence of visual impairment and blindness in older Icelanders: the Reykjavik Eye Study. Acta Ophthalmol Scand. 2010;88:358–66.
Buch H. Fourteen-year incidence of age-related maculopathy and cause-specific prevalence of visual impairment and blindness in a Caucasian population: the Copenhagen City Eye Study. Acta Ophthalmol Scand. 2005;83:400–1.
Acknowledgments
The authors would like to thank all administrative districts for the opportunity to analyse their data. We thank Ms. Agnes Christner, councilor at the Städtetag Baden-Württemberg, Ms. Christa Heilemann, councilor at the Landkreistag Baden-Württemberg and Mr. Andreas Grau of the Baden-Württemberg Ministry of Social Affairs for providing us with statistical data. We also thank Silke Haidekker, PhD, ELS, for editing the paper and revising the English language used in this manuscript. The project was supported by a grant from the German Ministry of Health and the German Diabetes Foundation. The German Diabetes Centre is financed by the German Federal Ministry of Health and by the Northrhine-Westphalian Ministry of Science.
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All authors declare that they have no conflicts of interest. We declare that the results presented in this paper have not been published previously in whole or in part.
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Claessen, H., Genz, J., Bertram, B. et al. Evidence for a considerable decrease in total and cause-specific incidences of blindness in Germany. Eur J Epidemiol 27, 519–524 (2012). https://doi.org/10.1007/s10654-012-9705-7
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DOI: https://doi.org/10.1007/s10654-012-9705-7