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  • normally The study by Wan Ling

    2019-05-09

    The study by Wan Ling Wong and colleagues examines the overall prevalence of age-related macular degeneration. In agreement with previous studies, Wong and colleagues have projected that 196 million people will be affected by age-related macular degeneration in 2020, increasing to 288 million by 2040. Their meta-analysis contributes to existing evidence by summarising and critically weighing up all available and reliable information on prevalence. However, questions still remain. Although the prevalence of a disease is interesting, it normally is not as important as knowing the overall disease burden. The authors do not report on visual acuity or the effect of vision loss on the quality of vision and quality of life. This aspect might be addressed in a future study. Another question refers to the factors associated with age-related macular degeneration and whether spectrum and influence of these factors differs between countries. In a similar manner, the question arises of why its prevalence varies between regions. The answers to these questions could help in the prevention of the disease, in elucidating the pathogenesis, and could give hints for the development of new therapeutic procedures. As with any study, this investigation has its limitations. A major inevitable limitation of such a study is that polypoidal vascular choroidopathy normally cannot reliably be differentiated from the exudative (wet) form of age-related macular degeneration. Since polypoidal vascular choroidopathy is markedly more common in Asia than in Europe, the prevalence of the exudative (late) form might have been overestimated for the Asian regions in Wong and colleagues\' meta-analysis, a point that is discussed by the authors. Therefore, rates of the both early and late type of age-related macular degeneration were possibly less frequent in the Asian populations than in the European populations assessed. Another limitation is that optical coherence tomography, a fairly new technique, was not applied in the preceding studies underlying the meta-analysis. Since optical coherence tomography is more precise in detecting morphological changes in the macula than the conventional procedure of examining fundus photographs, the prevalence of age-related macular degeneration might have been underestimated. Another unavoidable limitation of the study is opsins future developments might provide new therapies or prophylactic procedures that will reduce the number of patients affected by age-related macular degeneration. Finally, although macular degeneration, mainly age-related, was estimated to be the cause of 7% of blindness and 3% visual impairment worldwide, cataract and undercorrection of refractive error represented more than 50% of all cases. As devastating as the effect that age-related macular degeneration has on the quality of vision and quality of life, global public health measures that provide glasses and cataract surgery are by far more successful, safer, and more cost-effective than any therapy previously available for age-related macular degeneration.
    On Dec 11, 2013, UNICEF celebrates its 67th birthday. On that day, an estimated 380 000 children will be born worldwide. Only six out of ten of these births will be recorded with civil authorities. Article 7 in the UN Convention on the Rights of the Child regards birth registration immediately after birth as one of the fundamental human rights of children. If such formal recognition by the state does not occur, a child might be unable to obtain a birth certificate and thus be denied health care or education. The lack of registration might mean that a child enters into marriage or the labour market, or is recruited into the armed forces, before the legal age. If accused of a crime, unregistered children might be prosecuted as adults. Registering children at birth is the first step in securing their recognition before the law, safeguarding their rights, and ensuring that any violation of these rights does not go unnoticed.