Original article
Visual Impairment and Blindness Due to Macular Diseases Globally: A Systematic Review and Meta-Analysis

https://doi.org/10.1016/j.ajo.2014.06.012Get rights and content

Purpose

To estimate the number of people visually impaired or blind due to macular diseases except those caused by diabetic maculopathy.

Design

Meta-analysis.

Methods

Based on the Global Burden of Disease Study 2010 and ongoing literature research, we examined how many people were affected by vision impairment (presenting visual acuity <6/18, ≥3/60) and blindness (presenting visual acuity <3/60) due to macular diseases, with diabetic maculopathy excluded.

Results

In 2010, of 32.4 million blind people and 191 million vision-impaired people, 2.1 million (95% uncertainty interval [UI]: 1.9, 2.7) people were blind, and 6.0 million (95% UI: 5.2, 8.1) million were visually impaired due to macular diseases. In 2010, macular diseases caused 6.6% (95% UI: 6.0, 7.9) of all blindness and 3.1% (95% UI: 2.7, 4.0) of all vision impairment, worldwide. These figures were lower in regions with young populations than in high-income regions. Between 1990 and 2010, the number of people who were blind or visually impaired due to macular diseases increased by 36%, or 0.6 million people (95% UI: 0.5, 0.8) and by 81%, or 2.7 million (95% UI: 2.6, 3.9) people, respectively, whereas the global population increased by 30%. Age-standardized global prevalence of macula-related blindness and vision impairment in adults 50 years of age and older decreased from 0.2% (95% UI: 0.2, 0.2) in 1990 to 0.1% (95% UI: 0.1, 0.2) in 2010 and remained unchanged from 0.4% (95% UI: 0.3, 0.5) to 0.4% (95% UI: 0.4, 0.6), respectively.

Conclusions

In 2010, 2.1 million people were blind and 6.0 million people were visually impaired due to macular diseases, except those caused by diabetic maculopathy. Of every 15 blind people, 1 was blind due to macular disease, and of every 32 visually impaired people, 1 was visually impaired due to macular disease.

Section snippets

Methods

We systematically reviewed articles published between January 1980 and January 2012, we primarily identified 14 908 relevant manuscripts out of which 243 articles of high-quality, population-based studies remained after application of rigorous selection criteria and review by an expert panel.10, 11 The study was approved by the ethics committee II of the Medical Faculty Mannheim of the University of Heidelberg. We used MEDLINE, Embase and the World Health Organization library information

Results

Of 32.4 million people who were blind and 191 million people who were vision impaired in 2010,9 2.1 million (95% uncertainty interval (UI): 1.9, 2.7) people were blind, and 6.0 million (95% UI: 5.2, 8.1) million were visually impaired due to macular diseases, worldwide (Table 1).

Between 1990 and 2010, the number of people blind due to macular diseases increased by 0.6 million people, or 36%, and the number of visually impaired people by 2.7 million people, or 81%. During the same period the

Discussion

In 2010, of 32.4 million blind and 191 million vision impaired people, 2.1 million people were blind, and 6.0 million were visually impaired due to macular diseases, excepting those of diabetic maculopathy. The age-standardized prevalence of blindness related to macular diseases worldwide in adults aged 50 years or older in 2010 was 0.1 %, and the prevalence of moderate to severe visual impairment was 0.2%. These figures complement the findings obtained in a recent meta-analysis by Wong and

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