Causes of vision loss worldwide, 1990-2010: a systematic analysis
Causes of vision loss worldwide, 1990-2010: a systematic analysis
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DOI：
10.1016/s2214-109x(13)70113-x
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发表时间：
2013-12-01
影响因子：
34.3
通讯作者：
Taylor, Hugh R.
中科院分区：
文献类型：
--
作者：
Bourne, Rupert R. A.;Stevens, Gretchen A.;Taylor, Hugh R.
关于视力障碍和失明原因的数据对于制定公共卫生政策非常重要，方法对已发表和未发表的致盲资料进行系统分析（较佳眼的视力低于3/60）及中度及重度视力受损（[MSVI]视力较好的眼睛视力低于6/18，但至少3/60），从1980年到2012年。我们估计了1990-2010年按年龄、地理区域和年份划分的白内障、青光眼、黄斑变性、糖尿病视网膜病变、沙眼和未矫正屈光不正导致的总体视力损害的比例。百分之六十五（95%不确定性区间[UI] 61-68）全球3240万盲人和1.91亿MSVI患者中的76%（73-79）有可预防或可治疗的原因，而1990年为3180万人的68%（95%UI 65-70）和1.72亿人的80%（78-83）。1990年和2010年全球失明的主要原因是白内障（分别为39%和33%）、未矫正屈光不正（20%和21%）和黄斑变性（5%和7%），MSVI是未矫正屈光不正（51%和53%）、白内障（26%和18%）和黄斑变性（2%和3%）。失明的原因因地区而异。在世界范围内，在所有地区，更多的女性比男性失明或有MSVI由于白内障和黄斑变性。解释的差异和时间变化，我们发现失明的原因和MSVI的规划和资源分配的眼科护理的影响。
Background Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking.Methods We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990-2010 by age, geographical region, and year.Findings In 2010, 65% (95% uncertainty interval [UI] 61-68) of 32.4 million blind people and 76% (73-79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65-70) of 31.8 million and 80% (78-83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration.Interpretation The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care.