Rising to the challenge: estimates of the magnitude and causes of vision impairment and blindness.
Rising to the challenge: estimates of the magnitude and causes of vision impairment and blindness.
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DOI：
10.1016/s2214-109x(21)00008-5
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Cieza A
中科院分区：
文献类型：
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作者：
Keel S;Cieza A
世卫组织于1999年发起了《2020年愿景：视力权利》，以加强预防失明的活动。GBD 2019年失明和视力损害合作者在本期《柳叶刀全球健康》杂志中对视力损害和失明的全球规模和原因进行了估计，为眼科护理领域的行动和投资如何实现该倡议的目标提供了重要见解。从数据中可以清楚地看出，过去几十年的共同努力已经产生了相当大的红利，1990年至2020年期间报告的年龄调整失明患病率下降了27%。尽管如此，在同一时期，失明和中度和重度视力障碍的总人数大幅增加（分别增加了51%和92%）。这种增长的一个关键原因是，眼科保健服务一直无法跟上人口老龄化和增长的步伐，沿着行为和生活方式的变化，导致导致视力受损和失明的眼部疾病数量增加，如白内障，青光眼，年龄相关性黄斑变性，近视和糖尿病视网膜病变。从GBD合作者的估计中也可以明显看出，各地区之间在获得服务方面仍然存在严重的不平等：撒哈拉以南非洲西部和东部地区的年龄标准化失明患病率（每1000人中有11· 1和10· 7人，）和东南亚（每1000人中有10人）是所有高收入地区的五倍多（<2.0/1000）。作者的工作值得赞扬，他们的工作为理解视力障碍和失明的全球流行病学做出了重大贡献。这些数据将证明在增加宣传方面至关重要，并为该领域的公共卫生战略和新疗法的有效性提供重要见解。带回家的信息是明确的：（i）未矫正的屈光不正和未手术的白内障仍然是未完成的公共卫生议程上的主要项目，（ii）需要制定新的战略，以满足与非传染性慢性病迅速出现相关的复杂卫生系统要求。
Vision 2020: The Right to Sight launched by WHO in 1999 to intensify activities for the prevention of blindness. The estimates of the global magnitude and causes of vision impairment and blindness presented by the GBD 2019 Blindness and Vision Impairment Collaborators in this issue of The Lancet Global Health1, 2 offer important insights into how actions and investments in the field of eye care have delivered on the goals of this initiative. It is clear from the data that concerted efforts over the past decades have yielded considerable dividends, with a 27% reduction in the age-adjusted prevalence of blindness reported between 1990 and 2020. Despite this, the total number of individuals with both blindness and moderate and severe vision impairment has increased substantially (by 51% and 92%, respectively) during the same period. A key reason for this increase is that eye care services have been unable to keep pace with population ageing and growth, along with behavioural and lifestyle changes that have led to an increase in the number of eye conditions that cause vision impairment and blindness such as cataract, glaucoma, age-related macular degeneration, myopia, and diabetic retinopathy. It is also evident from the GBD Collaborators’ estimates that significant inequalities in access remain between regions: the age-standardised prevalence of blindness in regions of western and eastern sub-Saharan Africa (11· 1 and 10· 7 per 1000, respectively) and southeast Asia (10 per 1000) are over five times higher than in all high-income regions (< 2· 0 per 1000).The authors should be commended for their work, which makes a major contribution towards the understanding of the global epidemiology of vision impairment and blindness. These data will prove pivotal in increasing advocacy and offer important insights into the effectiveness of public health strategies and new treatments in the field. The take-home messages are clear:(i) uncorrected refractive error and unoperated cataract remain major items on the unfinished agenda of public health, and (ii) new strategies are needed to cater for the complex health system requirements associated with the rapid emergence of non-communicable chronic