Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.
OBJECTIVETo estimate global and regional trends from 1990 to 2010 of the prevalence and number of persons visually impaired specifically by diabetic retinopathy (DR), as a complication of the precipitous trends in global diabetes, is fundamental for health planning purposes. RESEARCH DESIGN AND METHODSThe meta-analysis of published population studies from 1990 to 2012 for the Global Burden of Disease Study 2010 (GBD) yielded estimated global regional trends in DR among other causes of moderate and severe vision impairment (MSVI; presenting visual acuity <6/18, ‡3/60) and blindness (presenting visual acuity <3/60). RESULTSGlobally in 2010, out of overall 32.4 million blind and 191 million visually impaired people, 0.8 million were blind and 3.7 million were visually impaired because of DR, with an alarming increase of 27% and 64%, respectively, spanning the two decades from 1990 to 2010. DR accounted for 2.6% of all blindness in 2010 and 1.9% of all MSVI worldwide, increasing from 2.1% and 1.3%, respectively, in 1990. These figures were lower in regions with younger populations (<2% in East and Southeast Asia and Oceania) than in high-income regions (North America, Western Europe, and Australasia) with relatively aging populations (>4%). CONCLUSIONSThe number of persons with visual impairment due to DR worldwide is rising and represents an increasing proportion of all blindness/MSVI causes. Age-standardized prevalence of DR-related blindness/MSVI was higher in sub-Saharan Africa and South Asia. One out of 39 blind people had blindness due to DR, and 1 out of 52 visually impaired people had visual impairment due to DR.Data on the prevalence of visual impairment and blindness, its causes, and its changes over time is of high importance for public health issues. On the basis of previous large-scale population-based studies and meta-analyses, diabetic retinopathy
PURPOSE.To estimate prevalence and number of people visually impaired or blind due to cataract. METHODS.Based on the Global Burden of Diseases Study 2010 and ongoing literature research, we examined how many people were affected by moderate to severe vision impairment (MSVI; presenting visual acuity <6/18, ‡3/60) and blindness (presenting visual acuity <3/60) due to cataract. RESULTS.In 2010, of overall 32.4 million blind and 191 million vision impaired, 10.8 million people were blind and 35.1 million were visually impaired due to cataract. Cataract caused worldwide 33.4% of all blindness in 2010, and 18.4% of all MSVI. These figures were lower in the high-income regions (<15%) and higher (>40%) in South and Southeast Asia and Oceania. From 1990 to 2010, the number of blind or visually impaired due to cataract decreased by 11.4% and by 20.2%, respectively; the age-standardized global prevalence of cataract-related blindness and MSVI reduced by 46% and 50%, respectively, and the worldwide crude prevalence of cataract-related blindness and MSVI reduced by 32% and 39%, respectively. The percentage of global blindness and MSVI caused by cataract decreased from 38.6% to 33.4%, and from 25.6% to 18.4%, respectively. This decrease took place in almost all world regions, except East Sub-Saharan Africa.CONCLUSIONS. In 2010, one in three blind people was blind due to cataract, and one of six visually impaired people was visually impaired due to cataract. Despite major improvements in terms of reduction of prevalence, cataract remains a major public health problem.Keywords: cataract, epidemiology, blindness, visual impairment A lthough cataract is relatively easily, safely, and costefficiently treatable, and in spite of the increasing rates of cataract surgery, 1 cataract is still the leading cause of blindness and visual impairment worldwide, especially in developing countries. 2,3 Population-based studies and previous meta-analyses performed in different regions worldwide have reported that cataract is responsible for 47.8% to 51% of all global blindness. 2,4-9 However, these studies did not report data on the change during the past 2 decades in terms of prevalence and number of people blind or visually impaired due to cataract.The purpose of the current study was to determine, in a meta-analysis of all available population-based studies performed worldwide within the past 2 decades, prevalence and number of people affected by blindness and visual impairment due to cataract, to assess changes during the period from 1990 to 2010, and to examine regional differences in the prevalence of cataract-related blindness and visual impairment.
In highly developed countries, prevalence of blindness and MSVI has been reduced by 50% and 38%, respectively, and the number of blind people and people with MSVI decreased by 17.4% and 12.6%, respectively, even with the increasing number of older people in the population. In high-income countries, macular degeneration has become the most important cause of blindness, but uncorrected refractive errors continue to be the leading cause of MSVI.
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