Causes of blindness and vision impairment in 2020 andtrends over 30 years, and prevalence of avoidable blindnessin relation to VISION 2020: the Right to Sight: an analysis forthe Global Burden of Disease Study
Kisa, Adnan; Bourne, Rupert R A; Steinmetz, Jaimie D; Briant, Paul Svitil; Flaxman, Seth R; Kisa, Sezer; Afshin, Ashkan; Vision Impairment Collaborator, GBD 2019 Blindness and; Vos, Theo; Mulaw, Getahun Fentaw; Resnikoff, Serge
Journal article, Peer reviewed
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https://hdl.handle.net/10642/9577Utgivelsesdato
2020-12-01Metadata
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Kisa A, Bourne, Steinmetz, Briant, Flaxman SR, Kisa S, Afshin A, Vision Impairment Collaborator, Vos T, Mulaw, Resnikoff S. Causes of blindness and vision impairment in 2020 andtrends over 30 years, and prevalence of avoidable blindnessin relation to VISION 2020: the Right to Sight: an analysis forthe Global Burden of Disease Study. The Lancet Global Health. 2020 https://doi.org/10.1016/ S2214-109X(20)30489-7Sammendrag
Background: Many causes of vision impairment can be prevented or treated. With an ageing global population, the
demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable
causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the
World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in
avoidable vision impairment, defined as cataract and undercorrected refractive error.
Methods: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980,
to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of
moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or
less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger
ages, our analysis focused on adults aged 50 years and older.
Findings: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did
not change between 2010 and 2019 (percentage change –0·2% [95% UI –1·5 to 1·0]; 2019 prevalence 9·58 cases per
1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised
prevalence of avoidable blindness decreased by –15·4% [–16·8 to –14·3], while avoidable MSVI showed no change
(0·5% [–0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and
MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were
cataract (15·2 million cases [9% IU 12·7–18·0]), followed by glaucoma (3·6 million cases [2·8–4·4]), undercorrected
refractive error (2·3 million cases [1·8–2·8]), age-related macular degeneration (1·8 million cases [1·3–2·4]), and
diabetic retinopathy (0·86 million cases [0·59–1·23]). Leading causes of MSVI were undercorrected refractive
error (86·1 million cases [74·2–101·0]) and cataract (78·8 million cases [67·2–91·4]).
Interpretation: Results suggest eye care services contributed to the observed reduction of age-standardised rates of
avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached.