Variations and trends in global disease burden of age-related macular degeneration: 1990-2017.

To evaluate the disease burden of age-related macular degeneration (AMD) and to evaluate the risk factors of disability-adjusted life years (DALY) caused by AMD. Country-specific DALY number, rate and age-standardized rate of AMD were acquired from the Global Burden of Disease Study 2017 database. The Socio-demographic Index (SDI), Human Development Index (HDI), Inequality-adjusted Human Development Index (IA-HDI) and other related data were obtained from published data or shared databases. Regression analysis was conducted to evaluate the correlations between the potential risk factors and the age-standardized DALY rate of AMD. The DALY number doubled from 1990 to 2017, and DALY rate increased from 4.73 (95% CI: 3.19-6.54) to 6.95 (95% CI: 4.76-9.54). However, change was small after standardizing. Females tended to have severer burden. Disability-adjusted life years (DALY) rates were correlated to annual PM2.5 concentration, gross domestic product (GDP) per capita, population with at least some secondary education (secondary education), glaucoma prevalence and gross national income (GNI) per capita. In SDI model, glaucoma, GDP, healthcare access and quality index (HAQ) and secondary education were associated with disease burden (p < 0.001). In IA-HDI model, cataract, glaucoma, PM2.5, GDP and secondary education were correlated to DALY rates (p < 0.001). In model included four components of HDI, glaucoma, PM2.5, GDP, secondary education, expected years of schooling and life expectancy at birth were associated (p < 0.001). Being female, older age, poor socioeconomic status and less educated are associated with a heavier disease burden of AMD. These findings would provide a basic understanding for policy making on AMD prevention and treatment.

Zou M ，Zhang Y ，Chen A ，Young CA ，Li Y ，Zheng D ，Jin G ... -  《-》

Disparities in the Global Burden of Age-Related Macular Degeneration: An Analysis of Trends from 1990 to 2015.

Wang D ，Jiang Y ，He M ，Scheetz J ，Wang W ... -  《-》

Time trends and heterogeneity in the disease burden of glaucoma, 1990-2017: a global analysis.

To evaluate the disease burden of glaucoma in terms of disability-adjusted life years (DALY) and assess the contribution of risk factors to DALY due to glaucoma. Global, regional, and country DALY number, rate, and age-standardized rates of glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), Inequality-Adjusted HDI, Socio-Demographic Index (SDI), and other country-level data were derived from international open databases. Regression analysis was used to assess the correlations between the age-standardized DALY rate and the variables. The global DALY due to glaucoma increased by 81% from 1990 to 2017 and decreased by 10% over the last two decades after adjusting for age and population size. Males had higher age-standardized DALY rates (P < 0.001). The age-standardized DALY rate was higher in countries with lower income or lower SDI (P < 0.001). The country-level age-standardized DALY rates in 2017 were negatively associated with HDI, SDI, country-level age-standardized prevalence rates of cataracts, cataract surgery rates (CRS), physician rates, and Inequality-Adjusted HDI. Stepwise multiple regressions showed that HDI, CRS, and Inequality-Adjusted HDI were significantly negatively associated with the country-level age-standardized DALY rate in 2017 after adjusting for other confounding factors (P < 0.001). Higher education, higher CRS, and diminishing the inequality in resource distribution may help reduce the disease burden of glaucoma. These findings can provide information for policymakers and could serve as an impetus for efforts toward alleviating the disease burden of glaucoma.

Zhang Y ，Jin G ，Fan M ，Lin Y ，Wen X ，Li Z ，Zeng P ，Zheng D ，Lan Y ... -  《-》

Variations and Trends in Health Burden of Visual Impairment Due to Cataract: A Global Analysis.

He M ，Wang W ，Huang W 《-》

Epidemiological variations and trends in health burden of glaucoma worldwide.

To evaluate the trends and variations in global health burden of glaucoma by year, age and sex, region and socio-economic status, using disability-adjusted life years (DALYs). The DALY numbers, crude DALY rate and age-standardized DALY rate globally and in each country were obtained the GBD 2015 study database. The corresponding human development index (HDI) and gross domestic product (GDP) per capita were obtained from the United Nations and World Bank. Environmental data were obtained from the WHO Global Health Observatory data repository. From 1990 to 2015, the DALY number and age-standardized DALY rate due to glaucoma increased by 122% and 15%, respectively. Both male and female showed similar increasing trend with ageing, with the peak at 60 years old and increasing again since 75 years old. Sex disparities in DALY number were noted, with higher burden among female than male in each age group (all p < 0.001). The health burden of glaucoma was substantial unequal, with Gini coefficient of 0.865 for DALY number, 0.235 for crude DALY rate and 0.254 for age-standardized DALY rate, respectively. The age-standardized DALY was significantly associated with HDI, accounting for 22.2% variance across countries (R2  = 0.222, p < 0.001). Similarly, the GDP per capita was inversely associated with age-standardized DALY rate but can explain only 10.6% variations in age-standardized DALY rate (R2  = 0.106, p < 0.001). The age-standardized DALY rate due to glaucoma was positively associated with national levels of ultraviolet radiation and PM2.5 . The health burden of glaucoma continuously increased in the past 25 years and distributed unequally. Lower socio-economic level, older age, female, higher ambient ultraviolet radiation and higher level of air pollution were significantly associated with higher burden of glaucoma.

Wang W ，He M ，Li Z ，Huang W ... -  《-》