Zou Minjie, Chen Aiming, Liu Zhenzhen, Jin Ling, Zheng Danying, Congdon Nathan, Jin Guangming
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
J Glob Health. 2024 Jun 14;14:04100. doi: 10.7189/jogh.14.04100.
Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment.
Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI).
In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden.
The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.
亚洲人口占世界人口的一半以上，承担着全球相当大比例的失明和视力损害负担。了解这一负担及其成因和决定因素，有助于制定有针对性的干预措施，以减少失明和视力损害的发生。
利用《2019年全球疾病负担研究》数据库，我们检索了1990年至2019年期间亚洲国家因六种原因（年龄相关性黄斑变性、白内障、青光眼、近视损害、屈光不正和其他视力丧失）导致的残疾调整生命年（DALYs）数量、粗率和年龄标准化率，以及失明和视力丧失的患病率（95%不确定区间）。我们将DALYs定义为因残疾而损失的年数和生命损失年数之和，并通过调整人口规模和年龄结构计算DALYs数量和患病率的年龄标准化数据。然后，我们评估了疾病负担的时间趋势，并按性别、年龄、地理位置和社会人口指数（SDI）进行了亚组分析。
2019年，与1990年相比，失明和视力丧失的DALYs和患病率分别上升了90.1%和116%，达到1584万DALYs（95%UI=1583,1585）和5.0671亿例（95%UI=5.0668,5.0674）。同时，1990年至2019年期间，DALYs的年龄标准化率有所下降。白内障、屈光不正和近视损害是最常见的三个原因。南亚地区的疾病负担最重（DALYs年龄标准化率为每10万人口517例；95%UI=512,521）。此外，白内障导致的负担在大多数亚洲人群中排名较高。女性、年龄较大以及国家SDI较低是与视力丧失负担较重相关的因素。
亚洲人群中视力丧失负担仍然很高。白内障、屈光不正和近视丧失是失明和视力丧失的主要原因。社会经济地位较低的国家需要加大对眼病预防和护理的投入，以及针对白内障管理、妇女和老年人的具体策略。
