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

Rupert R A Bourne^#¹, Jost B Jonas^#^{2

3}, Alain M Bron^{4

5

6

7}, Maria Vittoria Cicinelli⁸, Aditi Das⁹, Seth R Flaxman^{10

11}, David S Friedman¹², Jill E Keeffe¹³, John H Kempen^{14

15

16}, Janet Leasher¹⁷, Hans Limburg¹⁸, Kovin Naidoo¹⁹, Konrad Pesudovs²⁰, Tunde Peto²¹, Jinan Saadine²², Alexander J Silvester²³, Nina Tahhan^{24

25}, Hugh R Taylor²⁶, Rohit Varma²⁷, Tien Y Wong²⁸, Serge Resnikoff^{24

25}; Vision Loss Expert Group of the Global Burden of Disease Study

Affiliations

¹ Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK.
² Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany.
³ Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁴ INRA, UMR1324 Centre des Sciences du Goût et de l'Alimentation, Dijon, France.
⁵ CNRS, UMR6265 Centre des Sciences du Goût et de l'Alimentation, Dijon, France.
⁶ Centre des Sciences du Goût et de l'Alimentation, Université Bourgogne Franche-Comté, Dijon, France.
⁷ Ophthalmology Department, Dijon University Hospital, Dijon, France.
⁸ San Raffaele Scientific Institute, Milan, Italy.
⁹ Health Education Yorkshire and the Humber, Leeds, UK.
¹⁰ Department of Mathematics and Data Science Institute, Imperial College London, London, UK.
¹¹ Department of Statistics, University of Oxford, Oxford, UK.
¹² Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹³ LV Prasad Eye Institute, Hyderabad, India.
¹⁴ Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
¹⁵ Discovery Eye Center, Addis Ababa, Ethiopia.
¹⁶ Myungsung Christian Medical Center and Medical School, Addis Ababa, Ethiopia.
¹⁷ Nova Southeastern University, Davie, Florida, USA.
¹⁸ Health Information Services, Grootebroek, The Netherlands.
¹⁹ African Vision Research Institute, University of Kwazulu-Natal, Brien Holden Vision Institute, Durban, South Africa.
²⁰ NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, South Australia, Australia.
²¹ School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
²² Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
²³ St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
²⁴ Brien Holden Vision Institute, Sydney, New South Wales, Australia.
²⁵ School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
²⁶ Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia.
²⁷ Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California, USA.
²⁸ Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.

^# Contributed equally.

PMID: 29545417
PMCID: PMC5909755
DOI: 10.1136/bjophthalmol-2017-311258

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

Rupert R A Bourne et al. Br J Ophthalmol. 2018 May.

. 2018 May;102(5):575-585.

doi: 10.1136/bjophthalmol-2017-311258. Epub 2018 Mar 15.

Authors

Affiliations

¹ Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK.
² Department of Ophthalmology, Universitätsmedizin, Mannheim, Germany.
³ Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁴ INRA, UMR1324 Centre des Sciences du Goût et de l'Alimentation, Dijon, France.
⁵ CNRS, UMR6265 Centre des Sciences du Goût et de l'Alimentation, Dijon, France.
⁶ Centre des Sciences du Goût et de l'Alimentation, Université Bourgogne Franche-Comté, Dijon, France.
⁷ Ophthalmology Department, Dijon University Hospital, Dijon, France.
⁸ San Raffaele Scientific Institute, Milan, Italy.
⁹ Health Education Yorkshire and the Humber, Leeds, UK.
¹⁰ Department of Mathematics and Data Science Institute, Imperial College London, London, UK.
¹¹ Department of Statistics, University of Oxford, Oxford, UK.
¹² Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹³ LV Prasad Eye Institute, Hyderabad, India.
¹⁴ Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
¹⁵ Discovery Eye Center, Addis Ababa, Ethiopia.
¹⁶ Myungsung Christian Medical Center and Medical School, Addis Ababa, Ethiopia.
¹⁷ Nova Southeastern University, Davie, Florida, USA.
¹⁸ Health Information Services, Grootebroek, The Netherlands.
¹⁹ African Vision Research Institute, University of Kwazulu-Natal, Brien Holden Vision Institute, Durban, South Africa.
²⁰ NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, South Australia, Australia.
²¹ School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
²² Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
²³ St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
²⁴ Brien Holden Vision Institute, Sydney, New South Wales, Australia.
²⁵ School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
²⁶ Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia.
²⁷ Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California, USA.
²⁸ Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore.

^# Contributed equally.

PMID: 29545417
PMCID: PMC5909755
DOI: 10.1136/bjophthalmol-2017-311258

Abstract

Background: Within 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.

Methods: Based 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.

Results: Age-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.

Conclusions: While 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.

Keywords: epidemiology; glaucoma; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: JBJ: consultant for Mundipharma (Cambridge, UK), patent holder with Biocompatibles UK (Farnham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; patent no 20120263794) and patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4). AMB: consultant for Allergan, Bausch + Lomb, Carl Zeiss Meditec, Théa and VISUfarma. Research grants from Horus. JHK: consultant for Gilead and Santen. SR: consultant for Brien Holden Vision Institute.

Figures

**Figure 1**
Ladder plot showing the age-standardised prevalence of blindness in men and women aged 50+ years for 2015. These are modelled estimates using prevalence figures applied to the individual populations of countries (point estimates with 80% uncertainty intervals are displayed).

**Figure 2**
Ladder plot showing the age-standardised prevalence of moderate and severe vision impairment in men and women aged 50+ years for 2015. These are modelled estimates using prevalence figures applied to the individual populations of countries (point estimates with 80% uncertainty intervals are displayed).

**Figure 3**
Ladder plot showing the age-standardised prevalence of mild vision impairment in men and women aged 50+ years for 2015. These are modelled estimates using prevalence figures applied to the individual populations of countries (point estimates with 80% uncertainty intervals are displayed).

See this image and copyright information in PMC

References

1. GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability‐adjusted life years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990‐2015: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 Study. Lancet 2016;38:1603–58. - PMC - PubMed
1. Stevens GA, White RA, Flaxman SR, et al. . Global prevalence of vision impairment and blindness: magnitude and temporal trends, 1990-2010. Ophthalmology 2013;120:2377–84. 10.1016/j.ophtha.2013.05.025 - DOI - PubMed
1. Bourne RR, Jonas JB, Flaxman SR, et al. . Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe: 1990-2010. Br J Ophthalmol 2014;98:629–38. 10.1136/bjophthalmol-2013-304033 - DOI - PubMed
1. Bourne RR, Stevens GA, White RA, et al. . Causes of vision loss worldwide, 1990-2010: a systematic analysis. Lancet Glob Health 2013;1:e339–e349. 10.1016/S2214-109X(13)70113-X - DOI - PubMed
1. Bourne RRA, Flaxman SR, Braithwaite T, et al. . Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health 2017;5:e888–e897. 10.1016/S2214-109X(17)30293-0 - DOI - PubMed

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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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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MeSH terms

LinkOut - more resources

Full Text Sources

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