To investigate the association of sex with the global burden of glaucoma by year, age and socio-economic status using disability-adjusted life years (DALYs). Method: The global, regional and national sex-specific DALY numbers, crude DALY rates and age-standardized DALY rates caused by glaucoma, by year and age, were obtained from the Global Burden of Disease Study 2017. Human development index (HDI) in 2017 as a national socio-economic indicator was obtained from the Human Development Report. t-Test and linear regression were performed to explore the association between sex difference in agestandardized DALY rates and HDI. Results: Globally, changes in glaucoma DALY number and crude rates were similar of both sexes between 1990 and 2017. After controlling for population size and age structure, age-standardized DALY rates decreased consistently from 10.7 in 1990 to 9.4 in 2017 among men and from 8.8 in 1990 to 8.0 in 2017 among women. In 2017, the global average age-standardized DALY rates were 11.6 AE 8.6 (mean AE standard deviation) in women and 14.9 AE 12.1 in men. The sex difference in age-standardized DALY of 195 countries was significant (t = 3.109; p < .01) in 2017. Men had higher rates than women of the same age, and sexual differences increased with age. t-Test revealed that age-standardized DALY rates among men were higher than those among women for low-HDI countries (t = 3.102; p < .01) and high-HDI countries (t = 2.110; p < .05). The difference (male minus female) in age-standardized DALY rates (standardized b = À0.434, p < .001) and the female-to-male age-standardized DALY rate ratios (standardized b = À0.315, p < .001) were inversely correlated with HDI. Conclusion: Although global glaucoma health care is progressing, sexual differences in glaucoma burden showed little improvement in the past few decades. Worldwide, men have higher glaucoma burden than women. Older age and lower socio-economic status are associated with greater sex differences in glaucoma burden. Our findings may enhance public awareness of sexual differences in global glaucoma burden and emphasize the importance of making sex-sensitive health policy to manage global vision loss caused by glaucoma.

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Purpose: To investigate the surgical outcomes of the inverted internal limiting membrane (ILM) flap technique for macular hole retinal detachment (MHRD) in high myopia.Methods: This was a retrospective interventional study on 45 highly myopic eyes with MHRD after ILM peeling (n = 24, peeling group) or the inverted ILM flap technique (n = 21, inverted group). The inverted group was consisted of autologous blood (AB) subgroup (n = 10) and perfluorocarbon liquid (PFCL) subgroup (n = 11). MH closure, best-corrected visual acuity (BCVA), foveal microstructures, and excessive gliosis were analyzed during a follow-up of over 12 months.Results: The inverted group achieved a higher MH closure rate (95.24%) than the peeling group (41.67%; p &lt; 0.001). No significant difference was found in postoperative BCVA between the two groups (p = 0.98) or between the closed MH with or without excessive gliosis (p = 0.60). Excessive gliosis was identified in 9 eyes in the inverted group, and there was no difference in the incidence of excessive gliosis between the AB subgroup (4 in 10 eyes, 40%) and the PFCL subgroup (5 in 11 eyes, 45.45%) (p &gt; 0.999).Conclusion: The inverted ILM flap technique was effective in MH closure but had no advantage in postoperative BCVA and microstructural restoration. Excessive gliosis was only detected in the inverted group but did not affect the postoperative BCVA. Additionally, the incidence of excessive gliosis was not affected by adjuvants.

AimsTo investigate the sex-specific global burden of neonatal preterm birth (NPB) vision impairment by year, age, and socioeconomic status using years lived with disability (YLDs).MethodsThe global, regional, and national sex-specific YLD numbers, crude YLD rates, and age-standardized YLD rates of NPB-related moderate and severe vision loss and blindness were obtained from the Global Burden of Disease Study 2019. The Wilcoxon test and linear regression were used to investigate the relationship between sex difference in age-standardized YLD rates and the Human Development Index (HDI).ResultsBetween 1990 and 2019, the gender disparity in age-standardized YLD rates for NPB-related vision impairment remained stable, increasing from 10.2 [95% uncertainty interval (UI) 6.7–14.6] to 10.4 (95% UI 6.9–15.0) for men and 10.3 (95% UI 6.8–14.7) to 10.7 (95% UI 7.2–15.1) for women, with women consistently having higher age-standardized YLD rates. Between the ages of 25 and 75, women had higher YLD rates than males, with the biggest disparity in the 60–64 age group. In 2019, sex difference in age-standardized YLD rates across 195 nations was statistically significant. Women had higher age-standardized YLD rates than men in both low (Z = −3.53, p &lt; 0.001) and very high HDI countries (Z = −4.75, p &lt; 0.001). Additionally, age-standardized YLD rates were found to be adversely associated with HDI (male: Standardized β = −0.435, female: Standardized β = −0.440; p &lt; 0.001).ConclusionDespite advancements in worldwide NPB health care, sexual differences in NPB-related vision impairment burden showed little change. Female had higher burden than male, particularly in low and very high socioeconomic status countries.