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Visual impairment and blindness caused by retinal diseases: A nationwide register-based study
Chuandi Zhou1, Shu Li2, Luyao Ye1
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China.
Journal of Global Health
|November 3, 2023
Summary
Diabetic retinopathy (DR) is the leading cause of vision loss in China, affecting a significant proportion of patients with visual impairment and blindness. Targeted interventions for women, older adults, and underserved regions are crucial for mitigating this public health challenge.
Area of Science:
- Ophthalmology
- Public Health
- Epidemiology
Background:
- Retinal disorders represent a major global health concern, contributing significantly to visual impairment and blindness.
- Accurate data on vision loss prevalence is essential for effective eye healthcare planning and resource allocation.
- Understanding the specific burden of retinal diseases in China is critical for developing targeted interventions.
Purpose of the Study:
- To determine the proportion of visual impairment and blindness attributable to major retinal diseases in China.
- To identify the primary retinal diseases causing vision loss in the Chinese population.
- To analyze demographic and regional risk factors associated with vision loss from retinal disorders.
Main Methods:
- A nationwide register-based study encompassing 51 treatment centers across 31 provinces in mainland China.
- Inclusion of 28,320 adult patients diagnosed with retinal diseases, undergoing standardized ocular examinations.
- Utilized best-corrected visual acuity (BCVA) for defining visual impairment and blindness per WHO and US criteria, with logistic regression for risk factor analysis.
Main Results:
- Based on WHO criteria, 46% experienced unilateral visual impairment and 18% unilateral blindness; 31% had bilateral visual impairment and 3.3% bilateral blindness.
- Diabetic retinopathy (DR) was the leading cause, accounting for 32% of unilateral visual impairment, 60% of bilateral visual impairment, 35% of unilateral blindness, and 64% of bilateral blindness.
- Age-related macular degeneration, myopic maculopathy, retinal vein occlusion, and retinal detachment were other significant contributors. Women, older individuals (45+ years), and residents of Midwest China showed higher risks of vision loss.
Conclusions:
- Retinal disorders impose a substantial visual burden in China, with DR being the predominant cause of visual disabilities.
- Enhanced diabetes management and widespread screening programs are necessary to prevent DR-related vision loss.
- Specific attention and resources should be directed towards women, the elderly population, and less developed regions to address disparities in eye health outcomes.
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