全球近视负担导致的潜在生产力损失：系统评价、荟萃分析和建模。

Potential Lost Productivity Resulting from the Global Burden of Myopia: Systematic Review, Meta-analysis, and Modeling.

机构信息

Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; African Vision Research Institute, University of KwaZulu Natal, Durban, South Africa.

Brien Holden Vision Institute, Sydney, Australia.

出版信息

Ophthalmology. 2019 Mar;126(3):338-346. doi: 10.1016/j.ophtha.2018.10.029. Epub 2018 Oct 17.

DOI:10.1016/j.ophtha.2018.10.029

PMID:30342076

Abstract

PURPOSE

We estimated the potential global economic productivity loss resulting from vision impairment (VI) and blindness as a result of uncorrected myopia and myopic macular degeneration (MMD) in 2015.

CLINICAL RELEVANCE

Understanding the economic burden of VI associated with myopia is critical to addressing myopia as an increasingly prevalent public health problem.

METHODS

We estimated the number of people with myopia and MMD corresponding to critical visual acuity thresholds. Spectacle correction coverage was analyzed against country-level variables from the year of data collection; variation in spectacle correction was described best by a model based on a human development index, with adjustments for urbanization and age. Spectacle correction and myopia data were combined to estimate the number of people with each level of VI resulting from uncorrected myopia. We then applied disability weights, labor force participation rates, employment rates, and gross domestic product per capita to estimate the potential productivity lost among individuals with each level and type of VI resulting from myopia in 2015 in United States dollars (US$). An estimate of care-associated productivity loss also was included.

RESULTS

People with myopia are less likely to have adequate optical correction if they are older and live in a rural area of a less developed country. The global potential productivity loss associated with the burden of VI in 2015 was estimated at US$244 billion (95% confidence interval [CI], US$49 billion-US$697 billion) from uncorrected myopia and US$6 billion (95% CI, US$2 billion-US$17 billion) from MMD. Our estimates suggest that the Southeast Asia, South Asia, and East Asia Global Burden of Disease regions bear the greatest potential burden as a proportion of their economic activity, whereas East Asia bears the greatest potential burden in absolute terms.

CONCLUSIONS

Even under conservative assumptions, the potential productivity loss associated with VI and blindness resulting from uncorrected myopia is substantially greater than the cost of correcting myopia.

摘要

目的

我们评估了 2015 年未矫正近视和近视性黄斑变性（MMD）导致的视力损害（VI）和失明给全球经济生产力带来的潜在损失。

临床相关性

了解与近视相关的 VI 的经济负担对于解决近视这一日益普遍的公共卫生问题至关重要。

方法

我们根据关键性视力阈值评估了近视和 MMD 患者的数量。分析了 2015 年与各国数据采集年份相对应的眼镜矫正覆盖率；眼镜矫正的变化情况最好通过一个基于人类发展指数的模型来描述，该模型还针对城市化和年龄进行了调整。我们将眼镜矫正和近视数据结合起来，估算出由于未矫正近视而导致的不同程度 VI 的人数。然后，我们应用残疾权重、劳动力参与率、就业率和人均国内生产总值（GDP）来估算 2015 年由于近视导致的 VI 导致的个体潜在生产力损失。我们还包括了与护理相关的生产力损失的估计。

结果

年龄较大且生活在欠发达农村地区的近视患者获得适当光学矫正的可能性较低。2015 年，与 VI 负担相关的全球潜在生产力损失估计为 2440 亿美元（95%置信区间[CI]：490 亿美元-6970 亿美元），其中包括未矫正近视造成的损失和 60 亿美元（95% CI：20 亿美元-170 亿美元），为 MMD 造成的损失。我们的估计表明，东南亚、南亚和东亚全球疾病负担地区承担的潜在负担占其经济活动的比例最大，而东亚则以绝对数值承担的潜在负担最大。