Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future

Purpose Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. Design Meta-analysis of prevalence data. Participants A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. Methods AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). Main Outcome Measures Prevalence of early and late AMD, BCVA, and number of AMD cases. Results Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%–5.0%) in those aged 55–59 years to 17.6% (95%

Hepatitis C: Current options for nonresponders to peginterferon and ribavirin

Hepatitis C virus infection remains a significant health problem worldwide. The development of interferon-based therapies has led to increased success in eradicating this viral infection; however, no recent additions to the current treatment care regimen (peginterferon and ribavirin) have been made. Nonresponders to peginterferon/ribavirin make up a diverse patient population that can be difficult to manage. Through a better understanding of treatment response and viral kinetics, clinicians are employing altered dosing schedules to minimize the burden of viral illness. Consequently, clinicians can now manage nonresponders by providing supportive care and reserving retreatment for those most likely to respond to additional antiviral therapy, particularly when correctable factors from a previous treatment course with the potential for positive intervention have been identified. The decision for further medical management is based on clinical and laboratory parameters that have been shown to predict which patients will benefit most from another attempt at therapy