Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study.
Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study.
复制标题
2020年失明和视力障碍的原因和30年来的趋势，以及与VISION 2020：视力权利相关的可避免失明的患病率：全球疾病负担研究的分析。
DOI：
10.1016/s2214-109x(20)30489-7
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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
视力障碍的许多原因是可以预防或治疗的。随着全球人口的老龄化，人们对眼保健服务的需求也在不断增加。我们估计了1990年至2020年全球范围内可避免的致盲和视力障碍原因的患病率和相对贡献。我们的目的是将结果与世界卫生大会全球行动计划（WHA GAP）的目标进行比较，该目标是从2010年到2019年将全球可避免的视力障碍（定义为白内障和屈光不正）减少25%。我们对1980年1月至2018年10月期间基于人群的眼科疾病调查进行了系统回顾和荟萃分析。我们拟合了分层模型，以按病因、年龄、地区和年份估计中度和重度视力损害（MSVI;视力<6/18至3/60）和失明（<3/60或中心注视周围视野小于10°）的患病率（95%不确定区间[UI]）。由于年轻人的数据稀疏，我们的分析集中在50岁及以上的成年人身上。2010年至2019年期间，50岁及以上成年人可避免的视力障碍和失明的全球粗患病率没有变化（百分比变化−0·2% [95% UI −1·5至1·0]; 2019年患病率为9.58例/1000人[95%IU 8.51至10.8]，2010年患病率为96.0例/1000人[86.0至107.0]）。可避免的盲的标准化患病率下降了-15.4%[-16 statist 8至-14.3]，而可避免的MSVI没有变化（0.5%[-0 statist 8至1.6]）。然而，可避免盲（10.8%[8.9至12.4]）和MSVI（31.5%[30.0至33.1]）的病例数均有所增加。2020年全球50岁及以上人群失明的主要原因是白内障（1520万例[9% IU 12·7-18·0]），其次是青光眼（360万例[2·8-4·4]），屈光不正矫正不足（230万例[1·8-2·8]）、年龄相关性黄斑变性（180万例[1·3-2·4]）和糖尿病视网膜病变（86万例[0·59-1·23]）。MSVI的主要原因是屈光不正（86.1百万例[74.2 - 101.0]）和白内障（78.8百万例[67.2 - 91.4]）。结果表明，眼科保健服务有助于降低年龄标准化的可避免失明率，但不能降低MSVI，而且全球人口老龄化的目标没有达到。Brien霍尔顿视力研究所、Théa基金会、Fred Hollows基金会、比尔和梅林达·盖茨基金会、国际狮子会基金会、国际拯救视力组织和海德堡大学。
Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change −0·2% [95% UI −1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by −15·4% [–16·8 to −14·3], while avoidable MSVI showed no change (0·5% [–0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7–18·0]), followed by glaucoma (3·6 million cases [2·8–4·4]), undercorrected refractive error (2·3 million cases [1·8–2·8]), age-related macular degeneration (1·8 million cases [1·3–2·4]), and diabetic retinopathy (0·86 million cases [0·59–1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2–101·0]) and cataract (78·8 million cases [67·2–91·4]). Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached. Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.