Chen Jianqi, Zhu Yingting, Li Zhidong, Zhuo Xiaohua, Zhang Shaochong, Zhuo Yehong
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China.
Br J Ophthalmol. 2024 Oct 22;108(11):1605-1612. doi: 10.1136/bjo-2023-324086.
Cataract, glaucoma and age-related macular degeneration (AMD) are major causes of visual impairment. As these are age-related conditions, the prevalence of associated visual impairment is anticipated to increase as the population ages. However, age-period-cohort effects on the disease burden have not been investigated.
This was a population-based study using aggregated data from the Global Burden of Disease Study 2019. Age-period-cohort analysis was conducted using age-standardised prevalence rates (ASPRs) of visual impairment caused by cataract, glaucoma and AMD as disease burden indicator.
In 2019, the estimated global ASPRs of visual impairment due to cataract, glaucoma and AMD were 1207.9, 94.7 and 96.8 per 100 000 people, respectively. Between 1990 and 2019, the global visual impairment ASPRs for glaucoma and AMD declined by 15.4% and 2.0%, respectively, whereas that for cataract increased by 5.0%. Wide heterogeneity was observed in age-period-cohort effects on ASPRs across different Sociodemographic Index (SDI) regions. Low-middle SDI regions had the largest ASPR reductions for all three eye diseases and showed improvement in both period and cohort effects. In contrast, in high-middle SDI regions, visual impairment ASPRs significantly increased during the study period with unfavourable patterns.
The wide heterogeneity in age-period-cohort effects reflects different stages of societal transition and vision health. The unfavourable trends in age-period-cohort effects on disease prevalence identified in specific groups provide key information that may be used to identify priority groups in need of treatment and prevention.
白内障、青光眼和年龄相关性黄斑变性（AMD）是视力损害的主要原因。由于这些是与年龄相关的病症，随着人口老龄化，相关视力损害的患病率预计会增加。然而，年龄-时期-队列效应在疾病负担方面尚未得到研究。
这是一项基于人群的研究，使用了来自《2019年全球疾病负担研究》的汇总数据。以白内障、青光眼和AMD导致的视力损害的年龄标准化患病率（ASPR）作为疾病负担指标进行年龄-时期-队列分析。
2019年，因白内障、青光眼和AMD导致的视力损害的全球估计ASPR分别为每10万人1207.9、94.7和96.8。1990年至2019年期间，青光眼和AMD的全球视力损害ASPR分别下降了15.4%和2.0%，而白内障的则上升了5.0%。在不同社会人口指数（SDI）区域，年龄-时期-队列效应在ASPR方面存在广泛的异质性。低-中SDI区域在所有三种眼病中的ASPR下降幅度最大，并且在时期和队列效应方面均有所改善。相比之下，在高-中SDI区域，在研究期间视力损害ASPR显著增加，呈现不利趋势。
年龄-时期-队列效应的广泛异质性反映了社会转型和视力健康的不同阶段。在特定群体中确定的年龄-时期-队列效应在疾病患病率方面的不利趋势提供了关键信息，可用于确定需要治疗和预防的优先群体。
