2 research outputs found
Prevalence and Causes of Vision Loss in High-Income Countries and in Eastern and Central Europe in 2015: Magnitude, Temporal Trends, and Projections
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 were estimated for 1990, 2010, 2015, and 2020.
Results: Age-standardized 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 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 are needed
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Effectiveness of interventions to promote screening for diabetic retinopathy.
ObjectiveTo assess the effectiveness of interventions aimed to increase retinal screening among people with diabetes.MethodsA systematic literature search was conducted of multiple electronic bibliographic databases up to May 2005. Studies were included if interventions were used to promote screening for diabetic retinopathy in any language and with any study design.ResultsForty-eight studies (12 randomized controlled trials [RCTs], four nonrandomized studies, and 32 pre-post studies) with a total of 162,157 participants, examined a wide range of interventions, which focused on one or more of the following: (1) patients or populations, (2) providers or practices, and (3) healthcare system infrastructure and processes. Four of five RCTs focusing on patients demonstrated that interventions increased screening significantly, with relative risk ranging from 1.05 (95% confidence interval [CI]=1.01-1.08) to 2.01 (95% CI=1.48-2.73). Five RCTs with a focus on the system all demonstrated significant increases in screening with relative risk ranging from 1.12 (95% CI=1.03-1.22) to 5.56 (95% CI=2.19-14.10). Thirty-six non-RCTs, which included interventions with single or multiple foci, also generally demonstrated positive effects.ConclusionsIncreasing patient awareness of diabetic retinopathy, improving provider and practice performance, and improving healthcare system infrastructure and processes, can significantly increase screening for diabetic retinopathy. Further research should explore strategies for increasing the rate of retinal screening among diverse or disadvantaged populations and the economic efficiency of effective interventions in large community populations