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全球与近视性黄斑变性相关的视力障碍患病率及 2000 年至 2050 年的时间趋势:系统评价、荟萃分析和建模。

Global prevalence of visual impairment associated with myopic macular degeneration and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling.

机构信息

Brien Holden Vision Institute, Sydney, Australia.

School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.

出版信息

Br J Ophthalmol. 2018 Jul;102(7):855-862. doi: 10.1136/bjophthalmol-2017-311266. Epub 2018 Apr 26.

Abstract

PURPOSE

We used systematic review and meta-analysis to identify and assimilate evidence quantifying blindness and visual impairment (VI) associated with myopic macular degeneration (MMD), then derived models to predict global patterns. The models were used to estimate the global prevalence of blindness and VI associated with MMD from 2000 to 2050.

METHODS

The systematic review identified 17 papers with prevalence data for MMD VI fitting our inclusion criteria. Data from six papers with age-specific data were scaled to relative age-dependent risk and meta-analysed at VI and blindness levels. We analysed variance in all MMD VI and blindness data as a proportion of high myopia against variables from the place and year of data collection, with a model based on health expenditure providing the best correlation. We used this model to estimate the prevalence and number of people with MMD VI in each country in each decade.

RESULTS

We included data from 17 studies comprising 137 514 participants. We estimated 10.0 million people had VI from MMD in 2015 (prevalence 0.13%, 95% CI 5.5 to 23.7 million, 0.07% to 0.34%), 3.3 million of whom were blind (0.04%, 1.8 to 7.8 million, 0.03% to 0.10%). We estimate that by 2050, without changing current interventions, VI from MMD will grow to 55.7 million people (0.57%, 29.0 to 119.7 million, 0.33% to 1.11%), 18.5 million of whom will be blind (0.19%, 9.6 to 39.7 million, 0.11% to 0.37%).

CONCLUSION

The burden of MMD blindness and VI will rise significantly without efforts to reduce the development and progression of myopia and improve the management of MMD.

摘要

目的

我们使用系统评价和荟萃分析来确定和综合量化近视性黄斑变性(MMD)相关盲和视力障碍(VI)的证据,然后建立模型来预测全球模式。这些模型用于估计 2000 年至 2050 年期间与 MMD 相关的盲和 VI 的全球患病率。

方法

系统评价确定了 17 篇符合我们纳入标准的 MMD VI 患病率数据的论文。来自 6 篇具有特定年龄数据的论文的数据被扩展到相对年龄依赖性风险,并在 VI 和失明水平上进行荟萃分析。我们分析了所有 MMD VI 和失明数据的方差,作为高近视与数据收集地点和年份变量的比例,使用基于卫生支出的模型提供最佳相关性。我们使用该模型估计每个国家在每个十年中 MMD VI 患者的患病率和人数。

结果

我们纳入了 17 项研究,共包含 137514 名参与者。我们估计 2015 年有 1000 万人患有 MMD 引起的 VI(患病率为 0.13%,95%CI 550 万至 2370 万,0.07% 至 0.34%),其中 330 万人失明(0.04%,180 万至 780 万,0.03% 至 0.10%)。我们估计,如果不改变当前的干预措施,到 2050 年,MMD 引起的 VI 将增加到 5570 万人(0.57%,2900 万至 11970 万,0.33% 至 1.11%),其中 1850 万人失明(0.19%,960 万至 3970 万,0.11% 至 0.37%)。

结论

如果不努力减少近视的发展和进展,并改善 MMD 的管理,MMD 相关盲和 VI 的负担将显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea2b/6047154/2222fa55a3da/bjophthalmol-2017-311266f01.jpg

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