Ophthalmic epidemiology最新文献

Purpose: This study analyzes the prevalence, causes, and distribution of blindness and moderate-to-severe vision impairment (MSVI) in the Middle East and North Africa (MENA) using the Global Burden of Disease (GBD) 2019 dataset.

Methods: The GBD 2019 dataset was used to analyze vision impairment across 21 countries in MENA according to the Snellen chart classification (moderate vision impairment with presenting visual acuity worse than 6/18, severe impairment worse than 6/60, blindness worse than 3/60). Age-standardized prevalence and regional variations were compared to global averages. An exponential linear regression model was used to forecast MSVI and blindness in the year 2050.

Results: As of 2019, approximately 37.2 million people in MENA experienced blindness or vision loss. Although the age-standardized prevalence of vision impairment and blindness in MENA decreased from 1990 to 2019 due to improvements in healthcare, the absolute number has almost doubled (18.58 million in 1990 to 37.19 million in 2019) due to population growth and aging. Between 1990 to 2019, the population aged 70 and older in MENA grew from 7.2 million to over 19.2 million. Lastly, our predictions indicate an 86% increase in the number of individuals with vision loss by 2050.

Conclusion: The largest causes of moderate vision loss were refractive errors and cataracts, respectively, while the major causes of blindness were cataracts and glaucoma, respectively. The projection of increased vision impairment by 2050 underscores the urgent need for policy changes and efficient resource distribution to improve healthcare access and interventions.

Purpose: To report the prevalence, causes, and risk factors for unilateral visual impairment (UVI) among the elderly population (≥60 years) in Telangana, India.

Methods: A population-based, cross-sectional study was conducted in four districts of Telangana. Trained teams conducted eye examinations. Distance visual acuity (VA) was assessed using a Snellen chart with a tumbling E optotypes at 6 m. Anterior eye examination and non-mydriatic fundus imaging were performed for all participants. UVI was defined as presenting VA worse than 6/18 in one eye and VA better than or equal to 6/18 in the other eye. Multivariable analysis was performed to assess the factors associated with UVI.

Results: Of 2,447 participants aged ≥60 years were included in the analysis, 1,285 (52.5%) were women, and 1,786 (73%) had no formal education. In total, 525 (21.5%) participants were from Adilabad, 602 (24.6%) from Mahbubnagar, 610 (24.9%) from Khammam, and 710 (29%) from Warangal districts. The mean (standard deviation) age of the participants was 66.6 (±6.3) years. The prevalence of UVI was 34.9% (95% CI: 33.0-36.9; n = 856). Cataract (48.5%; n = 415) was the leading cause of UVI, followed by uncorrected refractive error (33.1%; n = 284). The multivariate analysis showed higher odds of UVI in the older age group and among those residing in the Khammam and Warangal districts.

Conclusion: Over a third of the elderly population in Telangana had UVI. Eight out of 10 cases of UVI could be addressed by providing spectacles and cataract surgery at primary and secondary levels of eye care, respectively.

Aim: To determine the prevalence and trends in vision impairment in South-East Asia and Oceania over the past 30 years.

Methods: We conducted a systematic review of medical literature and employed hierarchical models to estimate the prevalence of vision impairment (VI) in 2020 in South-East Asia and Oceania in those 50 + years of age. We estimated the prevalence (with 95% uncertainty intervals [UIs]) of mild VI (presenting visual acuity between ≥6/18 and <6/12), moderate and severe VI (MSVI) (presenting visual acuity less than 6/18 to 3/60), and blindness (presenting visual acuity less than 3/60 or less than 10° visual field around central fixation); we also estimated the prevalence of vision impairment due to uncorrected presbyopia (presenting near vision less than N6 or N8 at 40 cm where best-corrected distance visual acuity is ≥6/12).

Results: The prevalence of blindness in men and women in South-East Asia in 2020 was 3.05% (UI 2.58-3.49%) and 4.18% (UI 3.58-4.82%), respectively, with an age-standardised reduction of 32% for both sexes since 1990. The prevalence of MSVI in men and women in South-East Asia was 14.92% (UI 13.59-16.31%) and 15.77% (UI 14.41-17.19%), respectively, with an age-standardised reduction of 6.4% for men and 5.1% for women since 1990. The prevalence of blindness in men and women in Oceania was 1.74% (UI 1.43-2.04%) and 2.22% (1.84-2.61%), respectively, with an age-standardised reduction of 18% for both sexes. The prevalence of MSVI in men and women in Oceania in 2020 was 16.77% (14.78-18.79%) and 17.78% (15.82-19.92%), respectively, with an age-standardised reduction of 5.4% for men and 7.2% for women since 1990.

Conclusions: Although there has been a significant reduction in the prevalence of blindness in both South-East Asia and Oceania since 1990, the rates of mild to moderate visual impairment have only seen modest reductions. Furthermore, the absolute number blind in these regions increased from approximately 4.1 million in 1990 to 6.0 million in 2020.

Purpose: To estimate the prevalence of vision loss for 2020 in Latin America and the Caribbean (LAC) and analyse evolving trends since 1990.

Methods: A meta-analysis using hierarchical models of 37 sources of 33 cross-sectional, population-representative studies from LAC from 1998 to 2018 was undertaken to determine the prevalence of blindness, moderate and severe vision impairment (MSVI), and mild vision impairment (mild VI), with 95% uncertainty intervals (UIs).

Results: In 2020, the age-standardised prevalence rates of blindness, MSVI, moderate vision impairment (VI), severe VI, and mild VI, were 0.51% (95% UI 0.44%-0.57%), 3.73% (95% UI 3.38%-4.08%), 3.35% (95% UI 3.00%-3.69%), 0.38% (95% UI 0.34%-0.43%), and 3.19% (95% UI 2.87%-3.53%), respectively. In 1990, there were 15.81 million people with blindness and MSVI in LAC, contributing to 8.66% of the global caseload. In 2020, there were 30.42 million people, including 3.82 million (95% UI 3.14-4.55 million) with blindness and 26.6 million (95% UI 23.08-30.3 million) with MSVI, who contributed to 8.99% of the global caseload.

Conclusion: The contribution of vision loss to the overall global burden from LAC has increased over the last 3 decades, and the numbers of people affected with blindness and VI reported throughout the region have also steadily increased. There needs to be greater attention to providing universal eye health coverage across the region.

Purpose: To determine the magnitude and temporal trends of the prevalence of blindness and vision impairment (VI) in East Asia from 1990 to 2020.

Methods: A systematic review and meta-analysis of population-based studies was performed to estimate the prevalence and affected population of blindness (presenting visual acuity < 3/60 in the better eyes), moderate-to-severe vision impairment (MSVI; 3/60≤ presenting visual acuity < 6/18), mild VI (6/18≤ presenting visual acuity < 6/12) and near VI due to uncorrected presbyopia (presenting near vision

Results: In 2020, East Asia's age-standardized prevalence of blindness, MSVI, mild VI and near VI due to uncorrected presbyopia was 0.47% (95% uncertainty interval [UI], 0.41% to 0.52%), 2.77% (95% UI, 2.49% to 3.07%), 3.41% (95% UI, 3.06% to 3.78%), 7.38% (95% UI, 5.32% to 9.70%), with a higher prevalence in females compared to males. East Asians had lower prevalence of blindness and MSVI than the world population. Despite the decrease (27.7% for males and 27.1% for females) in age-standardized blindness prevalence in East Asia, the number of people with blindness and MSVI has increased from 7.0 to 9.1 million and 30.8 to 53.9 million from 2000 to 2020.

Conclusions: While age-standardized blindness rates have declined in the past two decades, yet the number of people affected by blindness and MSVI continues to rise, indicating unmet eye care demands in East Asia amid population growth and aging.

Purpose: To estimate the prevalence of vision loss for 2020 in South and Central Asia and analyze trends since 1990.

Methods: In a systematic literature review, we estimated the prevalence of blindness, visual impairment (VI) and presbyopia-related VI in 1990,2000,2010, and 2020.

Results: The study included 103 population-based studies. In South/Central Asia combined, age-standardized prevalence of blindness, moderate-to-severe VI (MSVI), moderate VI, severe VI, mild VI and presbyopia-related VI for all ages was 0.65% (95% uncertainty interval (UI):0.56/0.74), 5.06 (4.55/5.59), 4.40 (3.91/4.94), 0.65 (0.57/0.74), 3.21 (2.89/3.56), and 8.77 (6.37/11.48), respectively, with higher values for women than men. From 2000 to 2020, changes in age-standardized prevalence in South Asia were -36.85 (-36.94/-36.76), -7.01 (-7.13/-6.90), -5.86 (-5.99/-5.73), -13.96 (-14.09/-13.82), -9.55 (-9.66/-9.44), and -8.62 (-8.93/-8.31), respectively for men, and -38.50 (-38.59/-38.40), -10.12 (-10.22/-10.01), -9.23(-9.36/-9.10), -14.86 (-14.99/-14.73), -9.44 (-9.56/-9.33), and -7.78 (-8.09/-7.48), respectively for women. From 2000/2020, the changes in age-standardized prevalence figures in Central Asia were -21.44 (-21.58/-21.30), -2.75 (-2.87/-2.64), -2.17 (-2.30/-2.04), -7.12 (-7.26/-6.99), -5.36 (-5.48/-5.25), and -3.67(-4.02/-3.32), respectively for men, and -21.13 (-21.27/-20.99), -2.70 (-2.81/-2.58), -2.18 (-2.30/-2.05), -6.93 (-7.07/-6.80), -5.03 (-5.14/-4.91), and -2.65 (-3.00/-2.30), respectively, for women. In 2020, 11.94 million (9.98-14.07) and 0.30 million (0.24-0.36) individuals were blind, and 96.22 million (84.12-110.27) and 2.95 million (2.52-3.43) had MSVI in South Asia and Central Asia, respectively.

Conclusions: Despite a higher decrease between 2000 and 2020, the age-standardized prevalence of blindness and MSVI were higher in South Asia than in Central Asia in 2020. The number of people affected increased due to population growth and improved longevity.

Purpose: To assess burden of blindness and visual impairment (VI) in Sub-Saharan Africa (SSA) as of 2020, the planned end point of the Vision 2020 program.

Methods: A systematic review and meta-analysis assessed burden, in the better eye, of blindness (presenting distance visual acuity, VA < 3/60), moderate and severe vision impairment (MSVI; VA < 6/18 but ≥ 3/60) and mild vision impairment (VA < 6/12 and ≥ 6/18); and also functional presbyopia (

Results: In 2020, an estimated 5,083,000 people (95%Uncertainty Interval, UI, 4,474,000-5,696,000) in SSA were bilaterally blind; 20442,000 more (95%UI 18,568,000-22,430,000) had MSVI. The age-standardized prevalence of blindness in SSA is the highest for any GBD super-region, nearly double the world average (0.99%, 95%UI, 0.85-1.12; vs 0.52%, 95% UI, 0.46-0.59 respectively). The Western (4.15%) and Eastern (3.79%) SSA sub-regions had the highest age-standardized prevalence of blindness for the 50+ age group amongst SSA sub-regions. Improvement in age-specific prevalence since 2000 was less than the Vision 2020 target (-25%) for all subcategories of VI; improvement in blindness was the only category close to the goal (about 80-100% of goal across SSA sub-regions).

Conclusions: The SSA age-specific prevalence of VI has generally improved since 2000, especially for blindness. However, the number of VI cases has increased with population growth and aging, and Vision 2020 targets were not met. Because most causes of VI require individual-level clinical care, large increases in training and eye care delivery systems development/financing are critical areas of focus.

Purpose: In the UK, people are certified as severely sight impaired (SSI) or sight impaired (SI) according to Government guidelines. Certification ensures people with visual impairments can access adequate support and benefits. Certification of visual impairment data has been collected and analysed in Northern Ireland by a team and full continuous data is available from 2014 to 2023.Methods: Data from certification forms was collected, entered into an Excel spreadsheet, and 10% was validated by the certification of visual impairment team. This data was collated, cleaned and analysed using IBM SPSS (version 27) for frequency, mean, median and interquartile ranges.Results: Results show that over a 10-year period (2014-2023) the number of certifications in Northern Ireland has increased to a point where they are aligned with figures from other regions of the United Kingdom (UK). Results show that more people are certified as SSI than SI in Northern Ireland (NI) which is in contrast to figures reported in England and Wales. More females are certified than males in NI. Similarly to England and Wales, the most common cause of certification of visual impairment in adults in NI is Age-Related Macular Degeneration, accounting for around 50% of certifications annually. The second most common cause is glaucoma followed by diabetic eye disease (DED). In working age adults, DED is the leading cause of certification.Conclusion: The results from 10 years of certification data in NI show common themes with other high-income countries, including increased certification, particularly among females, and the most common causes of certification remain AMD, glaucoma and DED.

Purpose: To compare epidemiologic trends, clinical characteristics, and treatment patterns of acute postoperative endophthalmitis (APE) and endogenous endophthalmitis (EE) in a nationwide cohort.

Methods: This retrospective cohort study used Korean National Health Insurance Service claims data from 2013 to 2022. Patients with confirmed endophthalmitis treated by intravitreal injection (IVI) or pars plana vitrectomy (PPV) were included. A total of 7625 patients with APE and 649 with EE were analyzed. APE required recent intraocular surgery; EE required systemic infection and exclusion of corneal ulcer - associated endophthalmitis. Outcomes included yearly trends, patient profiles, treatment type (IVI, PPV, or combined), and outpatient care within one year.

Results: Among 16,009 patients with endophthalmitis, 7625 (47.6%) had APE and 649 (4.1%) had EE. APE cases increased until 2020-peaking during a fungal outbreak from contaminated viscoelastic material - then declined. The proportion of IVI-related APE rose from 13.1% in 2013 to 26.2% in 2022. EE cases remained stable. EE patients were younger (mean age, 62.6 vs. 67.6 years) and had greater comorbidity (mean Charlson Comorbidity Index, 1.30 vs. 0.98). IVI-only was most common in both groups, whereas combined IVI with PPV was more frequent in EE. Outpatient care was less common in EE (57.6% vs. 83.4%) yet lasted longer (median 269 vs. 67 days) with more IVIs (mean 3.48 vs. 2.62 injections).

Conclusion: APE was more prevalent and increasingly IVI-associated. EE, though less common, involved greater systemic morbidity and longer treatment duration. Findings underscore the need for infection control in IVI and multidisciplinary EE care.

Purpose: To assess the impact of social determinants of health (SDoH) and clinical factors on visual impairment (VI) at initial presentation to academic centers in cataract patients.

Methods: Multi-institutional cross-sectional study. We identified patients aged ≥40 years with cataract diagnosis using ICD-9 and ICD-10 codes from the Sight Outcomes Research Collaborative (SOURCE) Ophthalmology Data Repository. Best-recorded vision (BRV) at initial presentation, demographics, Charlson comorbidity index (CCI), cigarette smoking status, and Distressed Community Index (DCI) were recorded. BRV in the better eye was used to categorize VI as none/mild (BRV ≥20/40), moderate (20/40 < BRV < 20/200), and severe (BRV ≤ 20/200). Logistic regression models were used to assess the impact of clinical and sociodemographic factors on moderate and severe VI.

Results: Among 137,847 patients with a mean (SD) age of 67.4 (9.1), 58.6% (N = 77,425) were White, 22.5% (N = 29,725) were Black, and 8.8% (N = 11,562) were Hispanic/Latino. Adjusted logistic regression revealed Black patients (OR: 1.16; CI: 1.11-1.22), Native American patients (OR: 1.45; CI: 1.18-1.78), non-English speaking patients (OR: 1.79; CI: 1.69-1.91), and current smokers (OR: 1.29; CI: 1.22-1.37) had higher odds of severe VI. Higher DCI quintiles (more economically distressed) were associated with severe VI compared with the 1st (Prosperous) quintile: 2nd (OR 1.22; 95% CI 1.16-1.27), 3rd (OR 1.45; 95% CI 1.38-1.52), 4th (OR 1.56; 95% CI 1.47-1.64), and 5th (OR 1.36; 95% CI 1.29-1.44) quintiles.

Conclusions: This is one of the largest studies examining the impact of DCI on cataract related VI, highlighting the need for interventions to improve access to healthcare and prevent VI in these communities.