Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study.
Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study.
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30年来失明和远、近视力损害患病率的趋势：全球疾病负担研究的分析。
DOI：
10.1016/s2214-109x(20)30425-3
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Vision Loss Expert Group of the Global Burden of Disease Study
中科院分区：
文献类型：
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作者：
GBD 2019 Blindness and Vision Impairment Collaborators;Vision Loss Expert Group of the Global Burden of Disease Study
为促进世卫组织“2020年愿景：视力权利”倡议，需要对2020年全球视力障碍和时间变化进行评估。我们的目标是广泛更新全球视力丧失负担的估计，提出2020年的估计，1990-2020年间30年的时间变化，以及2050年的预测。我们对1980年1月至2018年10月期间基于人群的眼病调查进行了系统回顾和荟萃分析。只包括具有代表性的样本和明确定义的视力测试方案的研究。我们拟合了层次模型来估计2020年轻度视力障碍（视力≥6/18和<6/12）、中度和重度视力障碍（<6/18至3/60）和失明（<3/60或中心固定物周围视野小于10°）的患病率（95%不确定区间[UIs]）；未矫正老花眼造成的视力障碍（40 cm处近视力<N6或<N8，最佳矫正距离视力≥6/12）。我们预测到2050年的视力下降。2020年，估计有4330万人（95%）是盲人，其中2390万人（55%;20.8 - 26.8）为女性。我们估计有2.95亿人（267-325）患有中度和重度视力障碍，其中1.63亿人（55%;147-179）为女性；2.58亿人（233-285）患有轻度视力障碍，其中1.42亿人（55%;128-157）为女性；5.1亿人（371-667人）因未矫正老花眼而出现视力障碍，其中2.8亿人（55%；205-365人）为女性。在全球范围内，1990年至2020年间，50岁及以上的成年人中，年龄标准化的失明患病率下降了28.5%(- 29.4至- 27.7)，轻度视力障碍患病率略有下降（- 0.3%,- 0.8%至- 0.2%），而中度和重度视力障碍患病率略有上升（2.5%,- 0.9%至- 3.2%；没有足够的数据来计算未矫正老花造成的视力损害）。在此期间，盲人人数增加了50.6%（从47.8人增加到53.4人），中重度视力障碍人数增加了91.7%（从86.7%增加到95.8人）。我们预测，到2050年，全球将有61.0亿（52.9 - 69.3）人失明，4.74亿（4.28 - 518）人患有中度和重度视力障碍，3.6亿（3.22 - 400）人患有轻度视力障碍，8.66亿（6.29 - 1150）人患有未矫正的老花眼。在过去三十年中，经年龄调整的失明患病率有所下降，但由于人口增长，进展跟不上需求。随着全球人口的增长和老龄化，我们在避免视力损害方面面临着巨大的挑战。布莱恩霍尔顿视力研究所，西亚基金会，弗雷德霍洛斯基金会，比尔和梅林达盖茨基金会，狮子会国际基金会，国际观光者和海德堡大学。
To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990–2020, and forecasts for 2050. We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision <N6 or <N8 at 40 cm where best-corrected distance visual acuity is ≥6/12). We forecast estimates of vision loss up to 2050. In 2020, an estimated 43·3 million (95% UI 37·6–48·4) people were blind, of whom 23·9 million (55%; 20·8–26·8) were estimated to be female. We estimated 295 million (267–325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147–179) were female; 258 million (233–285) to have mild vision impairment, of whom 142 million (55%; 128–157) were female; and 510 million (371–667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205–365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (–29·4 to −27·7) and prevalence of mild vision impairment decreased slightly (–0·3%, −0·8 to −0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia. Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages. Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.