Xulu-Kasaba Zamadonda Nokuthula, Kalinda Chester
Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, University Road, Durban 4001, South Africa.
Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity (UGHE), Kigali P.O. Box 6955, Rwanda.
Trop Med Infect Dis. 2022 Feb 21;7(2):34. doi: 10.3390/tropicalmed7020034.
The prevalence of visual impairment (VI) continues to rise, despite efforts to reduce it. The burden of disease negatively impacts the quality of life, education opportunities, and other developments in various communities. Henceforth, this study aimed to determine and quantify the major causes of VI in South Africa, to ensure accurate interventions in addressing them and to reduce the burden of ocular disease in that context. A systematic scoping review was conducted to map evidence on VI and ocular diseases, using the PRISMA-P guidelines. English studies were searched for on PubMed, Google Scholar, and EBSCOhost using various search terms. The eligible articles underwent screening and ultimately data extraction to identify major causes of VI in South Africa. A meta-analysis further resulted in pooled prevalence estimates (PPE) using the Inverse Variance Heterogeneity (IVhet) model. Of the 13,527 studies screened at three levels, 10 studies met the inclusion criteria for the final review; however, 9 studies were eligible for quality assessment performed by two independent reviewers. The quality index for the included studies was 71.1%. The prevalence of VI was 2% for blindness and 12% for moderate and severe visual impairment (MSVI). Pooled prevalence identified uncorrected refractive error (URE) (43%), cataract (28%), glaucoma (7%), and diabetic retinopathy (4%) as major causes of MSVI. The leading causes of blindness were untreated cataracts (54%), glaucoma (17%), and diabetic retinopathy (57%). Ocular diseases causing VI are avoidable and similar to those of low-to-middle income countries. MSVI were caused by URE, cataract, glaucoma, and diabetic retinopathy. Blindness was mainly caused by cataracts, glaucoma, and diabetic retinopathy. A strategic plan to manage these conditions would largely reduce the burden of VI in the country. Early screenings and interventions to maximize care at primary health levels would decrease the burden of avoidable blindness in the country significantly.
尽管人们努力降低视力损害（VI）的发生率，但该疾病的患病率仍在持续上升。疾病负担对生活质量、教育机会以及各个社区的其他发展产生了负面影响。因此，本研究旨在确定并量化南非视力损害的主要原因，以确保针对这些原因采取准确的干预措施，并在这种情况下减轻眼部疾病的负担。我们按照PRISMA-P指南进行了一项系统的范围综述，以梳理有关视力损害和眼部疾病的证据。我们使用各种搜索词在PubMed、谷歌学术和EBSCOhost上搜索英文研究。符合条件的文章经过筛选，最终进行数据提取，以确定南非视力损害的主要原因。一项荟萃分析进一步使用逆方差异质性（IVhet）模型得出合并患病率估计值（PPE）。在三个层面筛选的13527项研究中，有10项研究符合最终综述的纳入标准；然而，有9项研究符合由两名独立评审员进行质量评估的条件。纳入研究的质量指数为71.1%。失明的视力损害患病率为2%，中度和重度视力损害（MSVI）的患病率为12%。合并患病率确定未矫正屈光不正（URE）（43%）、白内障（28%）、青光眼（7%）和糖尿病视网膜病变（4%）为MSVI的主要原因。失明的主要原因是未治疗的白内障（54%）、青光眼（17%）和糖尿病视网膜病变（57%）。导致视力损害的眼部疾病是可以避免的，且与中低收入国家的情况类似。MSVI由URE、白内障、青光眼和糖尿病视网膜病变引起。失明主要由白内障、青光眼和糖尿病视网膜病变引起。管理这些病症的战略计划将在很大程度上减轻该国视力损害的负担。在初级卫生保健层面进行早期筛查和干预以实现最大程度的护理，将显著减轻该国可避免失明的负担。
