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


Journal

The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041

Informations de publication

Date de publication:
07 2019
Historique:
received: 17 02 2018
revised: 19 06 2018
accepted: 24 06 2018
pubmed: 14 9 2018
medline: 18 2 2020
entrez: 14 9 2018
Statut: ppublish

Résumé

To 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. Based 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. The 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. In 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.

Sections du résumé

BACKGROUND
To 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.
METHODS
Based 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.
RESULTS
The 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.
CONCLUSIONS
In 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.

Identifiants

pubmed: 30209082
pii: bjophthalmol-2018-312068
doi: 10.1136/bjophthalmol-2018-312068
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

863-870

Informations de copyright

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

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 antiangiogenic factor; patent number: 20120263794) and patent application with the 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). JHK: consultant for Gilead and Santen. SR: consultant for Brien Holden Vision Institute.

Auteurs

Rim Kahloun (R)

Les Ophtalmologistes Associés de Monastir, Monastir, Tunisia.

Moncef Khairallah (M)

Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia moncef.khairallah@yahoo.fr.

Serge Resnikoff (S)

Brien Holden Vision Institute, Sydney, New South Wales, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Maria Vittoria Cicinelli (MV)

San Raffaele Scientific Institute, Milan, Italy.

Seth R Flaxman (SR)

Department of Mathematics and Data Science Institute, Imperial College London, London, UK.

Aditi Das (A)

Health Education Yorkshire and the Humber, London, UK.

Jost B Jonas (JB)

Department of Ophthalmology, Universitätsmedizin, Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Jill E Keeffe (JE)

L V Prasad Eye Institute, Hyderabad, India.

John H Kempen (JH)

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
MyungSung Christian Medical Center and Medical School, Discovery Eye Center, Addis Ababa, Ethiopia.

Janet Leasher (J)

Nova Southeastern University, Fort Lauderdale, Florida, USA.

Hans Limburg (H)

Health Information Services, Grootebroek, The Netherlands.

Kovin Naidoo (K)

Brien Holden Vision Institute, Sydney, New South Wales, Australia.
African Vision Research Institute, University of Kwazulu-Natal, Durban, South Africa.

Konrad Pesudovs (K)

5 Rose St, Glenelg, South Australia, Australia.

Alexander J Silvester (AJ)

St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.

Nina Tahhan (N)

Brien Holden Vision Institute, Sydney, New South Wales, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Hugh R Taylor (HR)

Melbourne School of Population Health, University of Melbourne, Parkville, Melbourne, Australia.

Tien Yin Wong (TY)

Singapore Eye Research Institute, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.

Rupert R A Bourne (RRA)

Vision and Eye Research Unit, School of Medicine, Anglia Ruskin University, Cambridge, UK.

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Classifications MeSH