[The status and changing trend in the burden of refractive errors in China from 1990 to 2019]

Objective: To comprehend the status and changing trend in the burden of refractive errors in China from 1990 to 2019, and to furnish data-driven support for the formulation of rational strategies in refractive error prevention and control. Methods: Using the Global Burden of Disease Database 2019, data on refractive error prevalence and years lived with disability (YLD) in China from 1990 to 2019 were extracted and their standardized rates were calculated. The trend of refractive error prevalence, age, period, and gender was analyzed using joinpoint regression models. Results: From 1990 to 2019, the number of cases, prevalence rate, and YLD rate of refractive errors in China showed an upward trend, which was consistent with global trends. However, the magnitude of the increase in these parameters was higher than the global average. Conversely, the age-standardized prevalence rate and age-standardized YLD rate demonstrated a declining trend, which was also consistent with global trends, but the reduction rate was less pronounced compared to global levels. Notably, all indicators for females, including prevalence and YLD, exceeded those of males. The prevalence and YLD rates of refractive errors in China increased with age. The older individuals had higher rates compared to younger individuals. In 1990, the highest prevalence and YLD rates were found in the ≥70 years group, while the lowest rates were in the <5 years group. The age group with the most substantial increase in the burden of refractive errors was the 15 to 49 years population, which remained consistent during the three decades. The joinpoint regression analysis results revealed a stage-wise fluctuation in the age-standardized prevalence and YLD rates of refractive errors in China from 1990 to 2019. Specifically, the age-standardized prevalence rate increased by 0.765% from 1990 to 2001, decreased by 0.963% from 2001 to 2014, increased by 4.214% from 2014 to 2017, and decreased by 3.029% from 2017 to 2019. In contrast, the age-standardized YLD rate decreased by 0.113% from 1990 to 1995, increased by 2.252% from 1995 to 2000, decreased by 1.102% from 2000 to 2014, increased by 4.326% from 2014 to 2017, and decreased by 5.090% from 2017 to 2019. Conclusions: The standardized prevalence of refractive errors and the standardized YLD rate in China showed a downward trend, which was less than the global average level, but the disease burden was still heavy. Gender and age emerged as significant influencing factors for the prevalence of refractive errors and YLD. It is imperative to enhance efforts in the prevention and treatment of refractive errors among the middle-aged and elderly population. Attention should also be directed towards the increasing burden in the<50 years population.