Tobacco-Attributable Age-Related Macular Degeneration Vision Impairment in Japan: A National and Prefecture-Level...

This study aimed to analyze the spatiotemporal burden of vision impairment due to age-related macular degeneration (AMD) in Japan from 1990 to 2021, projecting to 2040.

Using data from the Global Burden of Disease (GBD) study, we systematically analyzed the prevalence, disability-adjusted life years (DALYs), and temporal trends of vision impairment due to AMD in Japan from 1990 to 2021 and projected disease burden to 2040. We also quantified the burden of vision impairment due to AMD attributable to tobacco.

From 1990 to 2021, the number of AMD-related vision impairment cases increased by 159% to 93,310 (95% uncertainty interval [UI], 78,103-112,033); DALYs increased by 134% to 8907 (95% UI, 5984-12,298). However, the age-standardized prevalence rates declined from 22.3 to 19.73 per 100,000, and DALY rates decreased from 2.34 to 1.94. Prevalence was slightly higher in females, although the DALY rate difference was minimal. Burden disparities across all 47 prefectures were small. The contribution of tobacco to age-standardized DALYs decreased by 36.3%. Projections to 2040 estimate a 42.51% increase in total cases, with a rise in the age-standardized prevalence rate among males but a decline continuing among females.

Despite an increase in absolute cases, age-standardized rates of AMD-related vision impairment in Japan declined from 1990 to 2021, likely due to universal health insurance coverage and effective tobacco control policies. This supports ongoing investment to alleviate the burden in an aging society.

Translating 30-year population data, this study shows that tobacco control and healthcare equity reduce AMD-related vision impairment burden, informing vision loss prevention in aging societies.