Prevalence and causes of vision loss in East Asia in 2015: magnitude, temporal trends and projections

BackgroundTo determine the prevalence and causes of blindness and vision impairment (VI) in East Asia in 2015 and to forecast the trend to 2020.MethodsThrough a systematic literature review and meta-analysis, we estimated prevalence of blindness (presenting visual acuity <3/60 in the better eye), moderate-to-severe vision impairment (MSVI; 3/60≤presenting visual acuity <6/18), mild vision impairment (mild VI: 6/18≤presenting visual acuity <6/12) and uncorrected presbyopia for 1990, 2010, 2015 and 2020. A total of 44 population-based studies were included.ResultsIn 2015, age-standardised prevalence of blindness, MSVI, mild VI and uncorrected presbyopia was 0.37% (80% uncertainty interval (UI) 0.12%–0.68%), 3.06% (80% UI 1.35%–5.16%) and 2.65% (80% UI 0.92%–4.91%), 32.91% (80% UI 18.72%–48.47%), respectively, in East Asia. Cataract was the leading cause of blindness (43.6%), followed by uncorrected refractive error (12.9%), glaucoma, age-related macular degeneration, corneal diseases, trachoma and diabetic retinopathy (DR). The leading cause for MSVI was uncorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, corneal disease, trachoma and DR. The burden of VI due to uncorrected refractive error, cataracts, glaucoma and DR has continued to rise over the decades reported.ConclusionsAddressing the public healthcare barriers for cataract and uncorrected refractive error can help eliminate almost 57% of all blindness cases in this region. Therefore, public healthcare efforts should be focused on effective screening and effective patient education, with access to high-quality healthcare.

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Prevalence and causes of blindness and vision impairment: magnitude, temporal trends and projections in South and Central Asia

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312292 ◽

2018 ◽

Vol 103 (7) ◽

pp. 871-877 ◽

Cited By ~ 11

Author(s):

Vinay Nangia ◽

Jost B Jonas ◽

Ronnie George ◽

Vijaya Lingam ◽

Leon Ellwein ◽

...

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

South Asia ◽

Refractive Error ◽

Vision Loss ◽

Temporal Trends ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

Uncertainty Interval ◽

Age Related

BackgroundTo assess prevalence and causes of vision loss in Central and South Asia.MethodsA systematic review of medical literature assessed the prevalence of blindness (presenting visual acuity<3/60 in the better eye), moderate and severe vision impairment (MSVI; presenting visual acuity <6/18 but ≥3/60) and mild vision impairment (MVI; presenting visual acuity <6/12 and ≥6/18) in Central and South Asia for 1990, 2010, 2015 and 2020.ResultsIn Central and South Asia combined, age-standardised prevalences of blindness, MSVI and MVI in 2015 were for men and women aged 50+years, 3.72% (80% uncertainty interval (UI): 1.39–6.75) and 4.00% (80% UI: 1.41–7.39), 16.33% (80% UI: 8.55–25.47) and 17.65% (80% UI: 9.00–27.62), 11.70% (80% UI: 4.70–20.32) and 12.25% (80% UI:4.86–21.30), respectively, with a significant decrease in the study period for both gender. In South Asia in 2015, 11.76 million individuals (32.65% of the global blindness figure) were blind and 61.19 million individuals (28.3% of the global total) had MSVI. From 1990 to 2015, cataract (accounting for 36.58% of all cases with blindness in 2015) was the most common cause of blindness, followed by undercorrected refractive error (36.43%), glaucoma (5.81%), age-related macular degeneration (2.44%), corneal diseases (2.43%), diabetic retinopathy (0.16%) and trachoma (0.04%). For MSVI in South Asia 2015, most common causes were undercorrected refractive error (accounting for 66.39% of all cases with MSVI), followed by cataract (23.62%), age-related macular degeneration (1.31%) and glaucoma (1.09%).ConclusionsOne-third of the global blind resided in South Asia in 2015, although the age-standardised prevalence of blindness and MSVI decreased significantly between 1990 and 2015.

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Prevalence and causes of vision loss in South-east Asia and Oceania in 2015: magnitude, temporal trends and projections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-311946 ◽

2018 ◽

Vol 103 (7) ◽

pp. 878-884 ◽

Cited By ~ 7

Author(s):

Jill Elizabeth Keeffe ◽

Robert J Casson ◽

Konrad Pesudovs ◽

Hugh R Taylor ◽

Maria Vittoria Cicinelli ◽

...

Keyword(s):

East Asia ◽

Refractive Error ◽

Vision Loss ◽

Temporal Trends ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

South East Asia ◽

Near Vision ◽

Age Related ◽

Uncorrected Refractive Error

BackgroundTo assess prevalence and causes of vision impairment in South-east Asia and Oceania regions from 1990 to 2015 and to forecast the figures for 2020.MethodsBased on a systematic review of medical literature, prevalence of blindness (presenting visual acuity (PVA) <3/60 in the better eye), moderate and severe vision impairment (MSVI; PVA <6/18 but ≥3/60), mild vision impairment (PVA <6/12 but ≥6/18) and near vision impairment (>N5 or N8 in the presence of normal vision) were estimated for 1990, 2010, 2015 and 2020.ResultsThe age-standardised prevalence of blindness for all ages and both genders was higher in the Oceania region but lower for MSVI when comparing the subregions. The prevalence of near vision impairment in people≥50 years was 41% (uncertainty interval (UI) 18.8 to 65.9). Comparison of the data for 2015 with 2020 predicts a small increase in the numbers of people affected by blindness, MSVI and mild VI in both subregions. The numbers predicted for near VI in South-east Asia are from 90.68 million in 2015 to 102.88 million in 2020. The main causes of blindness and MSVI in both subregions in 2015 were cataract, uncorrected refractive error, glaucoma, corneal disease and age-related macular degeneration. There was no trachoma in Oceania from 1990 and decreasing prevalence in South-east Asia with elimination predicted by 2020.ConclusionsIn both regions, the main challenges for eye care come from cataract which remains the main cause of blindness with uncorrected refractive error the main cause of MSVI. The trend between 1990 and 2015 is for a lower prevalence of blindness and MSVI in both regions.

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Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: magnitude, temporal trends and projections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311258 ◽

2018 ◽

Vol 102 (5) ◽

pp. 575-585 ◽

Cited By ~ 77

Author(s):

Rupert R A Bourne ◽

Jost B Jonas ◽

Alain M Bron ◽

Maria Vittoria Cicinelli ◽

Aditi Das ◽

...

Keyword(s):

Refractive Error ◽

Vision Loss ◽

Temporal Trends ◽

Public Health Problem ◽

High Income ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

Important Public Health Problem ◽

Age Related ◽

Uncorrected Refractive Error

BackgroundWithin a surveillance of the prevalence and causes of vision impairment in high-income regions and Central/Eastern Europe, we update figures through 2015 and forecast expected values in 2020.MethodsBased on a systematic review of medical literature, prevalence of blindness, moderate and severe vision impairment (MSVI), mild vision impairment and presbyopia was estimated for 1990, 2010, 2015, and 2020.ResultsAge-standardised prevalence of blindness and MSVI for all ages decreased from 1990 to 2015 from 0.26% (0.10–0.46) to 0.15% (0.06–0.26) and from 1.74% (0.76–2.94) to 1.27% (0.55–2.17), respectively. In 2015, the number of individuals affected by blindness, MSVI and mild vision impairment ranged from 70 000, 630 000 and 610 000, respectively, in Australasia to 980 000, 7.46 million and 7.25 million, respectively, in North America and 1.16 million, 9.61 million and 9.47 million, respectively, in Western Europe. In 2015, cataract was the most common cause for blindness, followed by age-related macular degeneration (AMD), glaucoma, uncorrected refractive error, diabetic retinopathy and cornea-related disorders, with declining burden from cataract and AMD over time. Uncorrected refractive error was the leading cause of MSVI.ConclusionsWhile continuing to advance control of cataract and AMD as the leading causes of blindness remains a high priority, overcoming barriers to uptake of refractive error services would address approximately half of the MSVI burden. New data on burden of presbyopia identify this entity as an important public health problem in this population. Additional research on better treatments, better implementation with existing tools and ongoing surveillance of the problem is needed.

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Prevalence and causes of vision loss in North Africa and Middle East in 2015: magnitude, temporal trends and projections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312068 ◽

2018 ◽

Vol 103 (7) ◽

pp. 863-870 ◽

Cited By ~ 3

Author(s):

Rim Kahloun ◽

Moncef Khairallah ◽

Serge Resnikoff ◽

Maria Vittoria Cicinelli ◽

Seth R Flaxman ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Middle East ◽

North Africa ◽

Refractive Error ◽

Vision Loss ◽

Corneal Opacity ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

Age Related ◽

Uncorrected Refractive Error

BackgroundTo assess the prevalence and causes of vision impairment in North Africa and the Middle East (NAME) from 1990 to 2015 and to forecast projections for 2020.MethodsBased on a systematic review of medical literature, the prevalence of blindness (presenting visual acuity (PVA) <3/60 in the better eye), moderate and severe vision impairment (MSVI; PVA <6/18 but ≥3/60) and mild vision impairment (PVA <6/12 but ≥6/18) was estimated for 2015 and 2020.ResultsThe age-standardised prevalence of blindness and MSVI for all ages and genders decreased from 1990 to 2015, from 1.72 (0.53–3.13) to 0.95% (0.32%–1.71%), and from 6.66 (3.09–10.69) to 4.62% (2.21%–7.33%), respectively, with slightly higher figures for women than men. Cataract was the most common cause of blindness in 1990 and 2015, followed by uncorrected refractive error. Uncorrected refractive error was the leading cause of MSVI in the NAME region in 1990 and 2015, followed by cataract. A reduction in the proportions of blindness and MSVI due to cataract, corneal opacity and trachoma is predicted by 2020. Conversely, an increase in the proportion of blindness attributable to uncorrected refractive error, glaucoma, age-related macular degeneration and diabetic retinopathy is expected.ConclusionsIn 2015 cataract and uncorrected refractive error were the major causes of vision loss in the NAME region. Proportions of vision impairment from cataract, corneal opacity and trachoma are expected to decrease by 2020, and those from uncorrected refractive error, glaucoma, diabetic retinopathy and age-related macular degeneration are predicted to increase by 2020.

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Common age-related eye diseases and visual impairment

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0151 ◽

2017 ◽

pp. 1165-1170

Author(s):

Jacqueline Chua ◽

Ching-Yu Cheng ◽

Tien Yin Wong

Keyword(s):

Diabetic Retinopathy ◽

Visual Impairment ◽

Macular Degeneration ◽

Refractive Error ◽

Vision Loss ◽

Age Related Macular Degeneration ◽

Age Related ◽

Eye Disorders ◽

Appropriate Treatment ◽

Uncorrected Refractive Error

General physicians have an essential role in preventing vision loss in older people. However, most vision-threatening eye disorders are initially asymptomatic and often go underdiagnosed. Therefore screening, early detection, and timely intervention are important in their management. The most common cause of visual impairment is uncorrected or undercorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. Spectacles and cataract surgery can successfully restore sight for uncorrected refractive error and cataract, respectively. Visual impairment as a result of age-related macular degeneration, glaucoma, and diabetic retinopathy can be prevented with appropriate treatment if they are identified early enough. This chapter provides an overview of common age-related eye disease and visual impairment.

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Common age-related eye diseases and visual impairment

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0151_update_001 ◽

2017 ◽

pp. 1165-1170

Author(s):

Jacqueline Chua ◽

Ching-Yu Cheng ◽

Tien Yin Wong

Keyword(s):

Diabetic Retinopathy ◽

Visual Impairment ◽

Macular Degeneration ◽

Refractive Error ◽

Vision Loss ◽

Age Related Macular Degeneration ◽

Age Related ◽

Eye Disorders ◽

Appropriate Treatment ◽

Uncorrected Refractive Error

General physicians have an essential role in preventing vision loss in older people. However, most vision-threatening eye disorders are initially asymptomatic and often go underdiagnosed. Therefore, screening, early detection, and timely intervention are important in their management. The most common cause of visual impairment is uncorrected or under-corrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. Spectacles and cataract surgery can successfully restore sight for uncorrected refractive error and cataract, respectively. Visual impairment as a result of age-related macular degeneration, glaucoma, and diabetic retinopathy can be prevented with appropriate treatment if they are identified early enough. This chapter provides an overview of common age-related eye disease and visual impairment.

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Rapid assessment of prevalence of blindness and cataract surgery in Kabul province, Afghanistan

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2021-000790 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000790

Author(s):

Yuddha Sapkota ◽

Najeebullah Alizoi ◽

Abdul Majeed Siddiqi ◽

Mohammad Naseem ◽

Ahmad Shah Salaam ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Rapid Assessment ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

Age Related ◽

High Prevalence ◽

Uncorrected Refractive Error ◽

Estimate Prevalence

ObjectiveTo estimate prevalence and causes of blindness and vision impairment and assess cataract surgical coverage and quality of cataract surgery in Kabul.Methods and analysisA total of 3751 adults aged 50 years and above were recruited from 77 randomly selected clusters. Each participant underwent presenting and pinhole visual acuity assessment and lens examination. Those with pinhole visual acuity <6/12 in either eye had a dilated fundus examination to determine the cause of reduced vision. Those with apparent lens opacity were interviewed on barriers to cataract surgery.ResultsThe age-adjusted and sex-adjusted prevalence of blindness was 2.4% (95% CI: 1.8% to 3.0%). Prevalence of severe, moderate and mild vision impairment was 2.2% (95% CI: 1.7% to 2.7%), 6.9% (95% CI: 6.0% to 7.9%) and 8.7% (95% CI: 7.5% to 9.8%), respectively. Cataract was the main cause of blindness (36.8%), severe (54.4%) and moderate (46.1%) vision impairment. Uncorrected refractive error was the leading cause of mild vision impairment (20.3%). Age-related macular degeneration was the second leading cause of blindness (23.0%). In people with a presenting visual acuity of <3/60, cataract surgical coverage was 89.7%, and effective cataract surgical coverage was 67.8%. The major barriers to uptake of the available cataract surgical services were the need for surgery was not felt (23.7%) and cost (22.0%).ConclusionKabul province has a high prevalence of blindness, largely due to cataract and age-related macular generation. The quality of cataract surgery is also lagging in terms of good visual outcomes. This calls for immediate efforts to improving the reach and quality of existing eye services and readiness to respond to the increasing burden of posterior eye disease.

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Changes in visual acuity in patients with dry form of age-related macular degeneration after low-energy light therapy and medication

Oftalmologicheskii Zhurnal ◽

10.31288/oftalmolzh201652228 ◽

2016 ◽

Vol 63 (5) ◽

pp. 22-28

Author(s):

A. Sergienko ◽

◽

N. Dzyuba ◽

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Light Therapy ◽

Low Energy ◽

Age Related Macular Degeneration ◽

Age Related

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Genetic biomarkers in the VEGF pathway predicting response to anti-VEGF therapy in age-related macular degeneration

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000273 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000273

Author(s):

Irina Balikova ◽

Laurence Postelmans ◽

Brigitte Pasteels ◽

Pascale Coquelet ◽

Janet Catherine ◽

...

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Treatment Response ◽

Multiple Testing ◽

Age Related Macular Degeneration ◽

Patient Specific ◽

Multiple Testing Correction ◽

Anti Vegf ◽

Age Related ◽

Vegf Pathway

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.

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