Обзорная статья

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

Jaimie D SteinmetzUniversity of Washington [Seattle]Rupert BourneAnglia Ruskin UniversityPaul Svitil BriantUniversity of Washington [Seattle]Seth FlaxmanImperial College LondonHugh R B TaylorUniversity of MelbourneJost B. JonasUniversität Heidelberg [Heidelberg] = Heidelberg UniversityAmir AbdoliJahrom UniversityWoldu Aberhe AbrhaAksum UniversityAhmed AbualhasanCairo UniversityEman Girum Abu-GharbiehUniversity of SharjahTadele Girum Girum AdalWolkite UniversityAshkan AfshinUniversity of Washington [Seattle]Hamid AhmadiehShahid Beheshti University of Medical Sciences [Tehran]Wondu AlemayehuThe Fred Hollows FoundationSayyed Amirpooya AlemzadehIran University of Medical SciencesAhmed Samir AlfaarLeipzig University / Universität LeipzigVahid AlipourIran University of Medical SciencesSofia AndroudiUniversity of Thessaly [Volos]Jalal ArablooIran University of Medical SciencesAries ArditiBrhane Berhe AregawiAdigrat UniversityAlessandro ArrigoSan Raffaele HospitalCharlie AshbaughUniversity of Washington [Seattle]Elham AshrafiTehran University of Medical SciencesDesta Debalkie AtnafuBahir Dar UniversityEleni BagliUniversity Hospital of IoanninaAtif Amin BaigSultan Zainal Abidin UniversityTill BärnighausenUniversität Heidelberg [Heidelberg] = Heidelberg UniversityMaurízio Battaglia ParodiUniversita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie]Mahya BeheshtiTehran University of Medical SciencesAkshaya Srikanth BhagavathulaUniverzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]Nikha BhardwajPankaj BhardwajAll India Institute of Medical SciencesKrittika BhattacharyyaNational Institute of Biomedical GenomicsAli BijaniBabol University of Medical SciencesMukharram M. BikbovUfa Eye Research InstituteMichele BottoneImperial College LondonTasanee M BraithwaiteAlain M. BronUniversité Bourgogne Franche-Comté [COMUE]Sharath Burugina NagarajaEmployee State Insurance Post Graduate Institute of Medical Sciences and ResearchZahid A ButtUniversity of Waterloo [Waterloo]Florentino Luciano Caetano dos SantosEcole Polytechnique Fédérale de LausanneVera Lúcia Alves CarneiroUniversidade do Minho = University of Minho [Braga]Robert J. CassonUniversity of AdelaideChing-Yu Jasmine ChengSingapore Eye Research Institute [Singapore]Jee-Young Jasmine ChoiSeoul National University HospitalDinh‐Toi ChuHanoi National University of EducationMaria Vittoria CicinelliIRCCS San Raffaele Scientific Institute [Milan, Italie]João M G CoelhoUniversidade do Porto = University of PortoNathan CongdonQueen's University [Belfast]Rosa A A CoutoUniversity of PortoElizabeth A. CromwellUniversity of Washington [Seattle]Saad M A DahlawiUniversity of Dammam - Imam Abdulrahman Bin Faisal UniversityXiaochen DaiUniversity of Washington [Seattle]Reza DanaHarvard UniversityLalit DandonaUniversity of Washington [Seattle]Rakhi DandonaUniversity of Washington [Seattle]Monte A. Del MonteUniversity of Michigan [Ann Arbor]Meseret Derbew MollaUniversity of GondarNikolaos DervenisRoyal Liverpool University HospitalAbebaw Alemayehu DestaUniversity of GondarJenny P DevaUniversiti Tunku Abdul RahmanDaniel DíazUniversidad Nacional Autónoma de México = National Autonomous University of MexicoShirin E DjalaliniaMinistry of Health and Medical Education [Iran]Joshua R. EhrlichUniversity of Michigan [Ann Arbor]Rajesh ElayedathMahatma Gandhi University of Medical Sciences and TechnologyHala Rashad ElhabashyCairo University - Faculty of MedicineLeon B. EllweinNational Institutes of Health [Bethesda, MD, USA]Mohammad Hassan EmamianShahroud University of Medical SciencesSharareh EskandariehTehran University of Medical SciencesFarshad FarzadfarTehran University of Medical SciencesArthur Gustavo FernandesFederal University of Sao PauloFlorian FischerUniversity of Applied Sciences Ravensburg-WeingartenDavid S. FriedmanHarvard UniversityJoão M. FurtadoUniversidade de São Paulo = University of São PauloShilpa GaidhaneDatta Meghe Institute of Medical SciencesGus GazzardBerhe GebremichaelHaramaya UniversityRonnie GeorgeSankara Nethralaya Medical Research FoundationAhmad GhashghaeeIran University of Medical SciencesSyed Amir GilaniThe University of LahoreMahaveer GolechhaIndian Institute of Public Health GandhinagarSamer Randall HamidiHamdan Bin Mohammed Smart UniversityBilly R. HammondM. Elizabeth HartnettUniversity of UtahRisky Kusuma HartonoAbdiwahab HashiJigjiga UniversitSimon I HayUniversity of Washington [Seattle]Khezar HayatUniversity of Veterinary and Animal SciencesGolnaz HeidariHung Chak HoThe Chinese University of Hong Kong [Hong Kong]Ramesh HollaManipal academy of Higher EducationMowafa J HousehHamad Bin Khalifa UniversityJohn J. HuangYale University [New Haven]Segun Emmanuel IbitoyeUniversity of IbadanIrena IlićUniversity of Belgrade [Belgrade]Milena IlićFaculty of Science of the University of KragujevacApril IngramSeyed Sina Naghibi IrvaniShahid Beheshti University of Medical Sciences [Tehran]Sheikh Mohammed Shariful IslamDeakin University, Burwood, Australia

2020en

ABI

Аннотация

BACKGROUND: 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. METHODS: 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. FINDINGS: 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]). INTERPRETATION: 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. FUNDING: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

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Идентификаторы

DOI: 10.1016/s2214-109x(20)30489-7

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