Li Min, Jia Wenchang, Song Jianling, Ma Jiayi, Zhou Yanping, Han Yan, Peng Minghui, Zhou Jing, Chen Xiangwu, Li Xiaopan
Department of Ophthalmology, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China.
Department of Ophthalmology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Eye (Lond). 2025 Mar 11. doi: 10.1038/s41433-025-03743-z.
Cataracts, the leading cause of blindness globally, significantly impair vision and quality of life, particularly among the elderly. Despite advancements in cataract surgery, challenges in accessibility and economic disparities hinder the reduction of cataract burden, especially in low-income regions. This study examines the global prevalence and years lived with disability (YLDs) due to cataracts from 1990 to 2021, providing insights to inform public health strategies.
Utilizing data from the Global Burden of Disease (GBD) Study 2021, we analysed cataract prevalence and YLDs across 204 countries and territories. The estimates were stratified by age, sex, region, and Socio-Demographic Index (SDI) and compared across different time periods. Age-standardized rates (ASRs) and average annual percentage changes (AAPCs) were calculated to evaluate trends.
From 1990 to 2021, the global YLDs due to cataracts increased from 3.42 million to 6.55 million, a 91.8% rise. Most countries exhibited an increase in YLDs, with notable surges in low-SDI regions like Sub-Saharan Africa and South Asia. The AAPC for age-standardized prevalence rate (ASPR) was slightly positive globally, while the age-standardized YLD rate (ASYR) showed a decreasing trend, indicating improved cataract management. High-SDI regions experienced minor ASPR increases but significant ASYR reductions, reflecting effective interventions. Conversely, low-SDI regions saw declines in both ASPR and ASYR, though disparities persisted.
The burden of cataracts remains substantial, with significant increases in YLDs driven by aging populations and improved diagnostic capabilities. Effective management strategies have reduced ASYRs, particularly in high-SDI regions. Addressing cataract burden in low-SDI regions requires enhanced healthcare access, targeted public health interventions, and global support. These findings underscore the need for continued investment in cataract prevention and treatment to mitigate the global impact.
白内障是全球失明的主要原因，严重损害视力和生活质量，在老年人中尤为如此。尽管白内障手术取得了进展，但可及性方面的挑战和经济差距阻碍了白内障负担的减轻，尤其是在低收入地区。本研究调查了1990年至2021年全球白内障的患病率和因白内障导致的残疾生存年数（YLDs），为公共卫生策略提供参考依据。
利用《2021年全球疾病负担（GBD）研究》的数据，我们分析了204个国家和地区的白内障患病率和YLDs。估计数按年龄、性别、地区和社会人口指数（SDI）进行分层，并在不同时间段进行比较。计算年龄标准化率（ASRs）和年均变化百分比（AAPCs）以评估趋势。
从1990年到2021年，全球因白内障导致的YLDs从342万增加到655万，增长了91.8%。大多数国家的YLDs都有所增加，撒哈拉以南非洲和南亚等低SDI地区出现了显著增长。全球年龄标准化患病率（ASPR）的AAPC略有正值，而年龄标准化YLD率（ASYR）呈下降趋势，表明白内障管理有所改善。高SDI地区的ASPR略有增加，但ASYR显著下降，反映了有效的干预措施。相反，低SDI地区的ASPR和ASYR均有所下降，尽管差距依然存在。
白内障负担仍然很重，人口老龄化和诊断能力的提高导致YLDs显著增加。有效的管理策略降低了ASYRs，尤其是在高SDI地区。解决低SDI地区的白内障负担需要增加医疗服务可及性、有针对性的公共卫生干预措施和全球支持。这些发现强调了持续投资于白内障预防和治疗以减轻全球影响的必要性。
