Nejatian Marcel M, Bhat Saiuj, Kalantary Amy, Taylor Joshua R, Chia Mark A, Turner Angus W, Razavi Hessom
Lions Eye Institute, Nedlands, Western Australia, Australia
University of Western Australia Centre for Ophthalmology and Visual Science, Perth, Western Australia, Australia.
BMJ Open Ophthalmol. 2025 Jan 11;10(1):e001847. doi: 10.1136/bmjophth-2024-001847.
Compare the prevalence of age-related cataract and the cataract surgical coverage rate between Indigenous and non-Indigenous Australians and explore differences in these estimates across location and time.
The Joanna Briggs Institute guidance for systematic reviews of prevalence studies was followed. A systematic search of Medline, Embase, Web of Science and grey literature from database inception to June 2022 was performed. All studies reporting cataract prevalence in Australian populations were included. Pooled prevalence estimates were derived using meta-analyses with a random-effects model. Nine studies enrolling 36 302 participants were included. Most studies only reported the prevalence of cataract causing vision loss (visual acuity<6/12) or blindness (visual acuity<6/60), restricting our meta-analysis to these definitions.
Cataract causing unilateral vision loss was common in both Indigenous and non-Indigenous adults (3.5% and 3.6%, p=0.891). Indigenous adults had a higher prevalence of bilateral vision loss (3.6% vs 1.1%, p=0.011) and bilateral blindness (0.385% vs 0.001%, p=0.002) than non-Indigenous adults. Cataract surgical coverage was lower in Indigenous (68.0%; 95% CI, 55.9 to 79.0) than non-Indigenous (88.4%; 95% CI, 79.9 to 94.8) adults (p=0.004). No differences in bilateral vision loss, blindness or surgical coverage were found between rural and urban subgroups or between studies conducted before and after the year 2000.
Cataract causes vision loss in a substantial number of adults living in urban and rural Australia. Policies to improve diagnosis and surgery rates should be prioritised, particularly for Indigenous Australians who experience a disproportionate burden of advanced cataract and reduced access to surgery.
CRD42022340197.
比较澳大利亚原住民和非原住民年龄相关性白内障的患病率以及白内障手术覆盖率，并探讨这些估计值在不同地点和时间的差异。
遵循乔安娜·布里格斯研究所关于患病率研究系统评价的指南。对Medline、Embase、科学引文索引以及自数据库创建至2022年6月的灰色文献进行系统检索。纳入所有报告澳大利亚人群白内障患病率的研究。采用随机效应模型进行荟萃分析得出合并患病率估计值。纳入了9项研究，共36302名参与者。大多数研究仅报告了导致视力丧失（视力<6/12）或失明（视力<6/60）的白内障患病率，因此我们的荟萃分析仅限于这些定义。
导致单侧视力丧失的白内障在原住民和非原住民成年人中都很常见（分别为3.5%和3.6%，p = 0.891）。与非原住民成年人相比，原住民成年人双侧视力丧失（3.6%对1.1%，p = 0.011）和双侧失明（0.385%对0.001%，p = 0.002）的患病率更高。原住民成年人的白内障手术覆盖率（68.0%；95%可信区间，55.9至79.0）低于非原住民成年人（88.4%；95%可信区间，79.9至94.8）（p = 0.004）。在农村和城市亚组之间或2000年之前和之后进行的研究之间，未发现双侧视力丧失、失明或手术覆盖率存在差异。
白内障导致澳大利亚城乡大量成年人视力丧失。应优先制定改善诊断和手术率的政策，特别是对于晚期白内障负担过重且手术机会减少的澳大利亚原住民。
PROSPERO注册号：CRD42022340197。
