Future sight loss in the decade 2010 to 2020: an epidemiological and economic model icon

Future sight loss in the decade 2010 to 2020: an epidemiological and economic model


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Future sight loss in the decade 2010 to 2020: an epidemiological and economic model.

Report prepared for RNIB by Darwin Minassian and Angela Reidy.

EpiVision.

July 2009.

Advisory Committee


Jennifer Beecham, Henry Cutler, Parul Desai, Alistair Fielder, Anita Lightstone, David Lye, Pritti Mehta, Lynne Pezzullo, John Ravenscroft, and Steve Winyard.



Table of Contents


Future sight loss in the decade 2010 to 2020: an epidemiological and economic model. 1

Report prepared for RNIB by Darwin Minassian and Angela Reidy. 1

EpiVision. 1

July 2009. 1

Advisory Committee 1

Table of Contents 2

Executive summary 7

Commissioned brief 7

Structure of the report 7

Key findings 8

Age-related Macular Degeneration (AMD) 8

Cataract 11

Diabetic Retinopathy (DR) 12

Glaucoma 13

Observation by the authors 15

Demography 17

Part 1: Age–related Macular Degeneration 19

Terminology and Definitions 19

Section 1: Epidemiology 20

Section 2: Costs to Society 22

Section 3: Varying Assumptions 30

Part 2: Cataract 33

Terminology and Definitions 33

Section 1: Epidemiology 35

Section 2: Costs to Society 37

Section 3: Varying Assumptions 44

Part 3: Diabetic Retinopathy 47

Terminology and Definitions 47

Section 1. Epidemiology 48

Section 2: Costs to Society 52

Part 4: Glaucoma 60

Terminology and Definitions 60

Section 1: Epidemiology 60

Section 2: Costs to Society 65

Section 3: Varying Assumptions 72

Observation of the Authors 78

Appendix 1 – Methods – Epidemiology and Modelling 82

The Decade Model - Overview 82

The Epidemiology Module 83

Cataract – Methods for Epidemiological Estimates 92

Diabetic Retinopathy – Methods for Epidemiological Estimates 96

Glaucoma & Ocular Hypertension (OH) 98

References – Epidemiology 102

Appendix 2 – Methods – Economics 108

References - Economics 117

Sources and Notes 132



List of Tables



Table P-1. UK Population at Risk – AMD



Table AMD 1. Age-related macular degeneration and sight loss attributed to AMD. Estimated number of affected persons (Treatment coverage for NV AMD at 75 per cent per cent).


Table AMD 2. Cumulative cost of illness for AMD over the decade and the cost at base year 2010 (Treatment coverage for Neovascular AMD is 75 per cent.)


Tables AMD 3 (a)-(d). Cumulative cost of illness for AMD over the decade and the cost at base year 2010 by UK country (Treatment for NV/ AMD: 75 per cent).


Table AMD 4. Cumulative Cost of illness and number of persons with sight loss due to Neovascular AMD, by levels of treatment coverage. Estimates for the UK.


Table AMD 5. Gain in visual acuity over the decade with Ranibizumab treatment. Estimates for the UK.


Table P-2. Population at Risk – Cataract


Table CAT 1. Cataract Operations, main complications, and sight loss due to Cataract. Estimated numbers projected to year 2020.


Table CAT 2. Cumulative cost of illness for cataract over the decade and the cost at base year 2010, for the UK.


Tables CAT 3 (a)-(d). Cumulative cost of illness for cataract over the decade and the cost at base year 2010 by UK country.


Table CAT 4. Number of endophthalmitis cases in the year 2010 in the UK, and the cost of illness, according to two assumptions regarding incidence rates.


Table P-3. Population at Risk – Diabetic Retinopathy


Table DR 1. Diabetes, diabetic retinopathy (DR), and sight loss due to DR. Estimated numbers projected to year 2020.


Table DR 2. Cumulative cost of illness for diabetic retinopathy (DR) over the decade and the cost at base year 2010, for the UK.


Tables DR 3 (a)-(d). Cumulative cost of illness for diabetic retinopathy (DR) over the decade and the cost at base year 2010 by UK country.


Table P-4. UK. Population at Risk – Glaucoma & Ocular Hypertension


Table GL 1(a). Glaucoma, ocular hypertension, and sight loss. Estimated number of affected persons by UK country.(a) All ethnic groups Detection rate = 50 per cent.


Table GL 1(b). Glaucoma, ocular hypertension, and sight loss. Estimated number of affected persons by UK country. (b)African-Caribbean group: Detection rate = 50 per cent.


Table GL 2. Cumulative cost of illness for glaucoma (including Ocular hypertension) for the decade and for base year, 2010 UK. Detection rate = 50 per cent.


Tables GL 3 (a)-(d). Cumulative cost of illness for glaucoma over the decade and the cost at base year 2010 by UK country. Detection rate = 50 per cent.


Table GL 4. Glaucoma, ocular hypertension, and sight loss due to glaucoma. Estimated number of diagnosed cases for the UK in relation to the assumed detection rate.


Table GL 5. Cumulative cost of illness for glaucoma and ocular hypertension over the decade and the cost at base year 2010. Assumption 2: improved detection rate = 75 per cent.


Table GL 6. Cumulative cost of illness for glaucoma and ocular hypertension over the decade and the cost at base year 2010. Assumption 3: improved detection rate = 90 per cent.


Table GL 7. Cumulative cost of illness and number of persons with sight loss due to glaucoma, at 3 levels of detection rate. Estimates for the UK.






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