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Arazi M, Bal S, Ehrlich JR, O'Banion J, Shakarchi F. Global Ophthalmology in the Middle East: a Task Force proposal. Eye (Lond) 2024; 38:1986-1987. [PMID: 38486118 PMCID: PMC11269660 DOI: 10.1038/s41433-024-03020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/13/2024] [Accepted: 03/06/2024] [Indexed: 07/26/2024] Open
Affiliation(s)
- Mattan Arazi
- Sheba Global Ophthalmology, Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel.
| | - Sila Bal
- Department of Ophthalmology, Moran Eye Center, Salt Lake City, UT, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Jacquelyn O'Banion
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Fatma Shakarchi
- International Committee of the Red Cross, Geneva, Switzerland
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2
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Khatami K, Estedlal A, Vali M, Kamalipour A, Mahmoudinezhad G, Nejabat M, Nowroozzadeh MH, Vardanjani HM. Prevalence and secular trends of four causes of blindness and visual impairment in Iran (1990-2019): a comparative study based on the Global Burden of Disease project's data. Int Ophthalmol 2023; 43:4719-4728. [PMID: 37713146 DOI: 10.1007/s10792-023-02872-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE The purpose of this study was to investigate the prevalence of cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma, as well as their trends from 1990 to 2019 in Iran, in comparison with high-middle socio-demographic index (HMSDI) countries and the world, using the Global Burden of Disease (GBD) 2019 study. METHODS The GBD study provided data on the prevalence of blindness and visual impairment (VI), as well as four of their causes including cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma. Using Joinpoint analysis, the annual percent change (APC) was calculated to assess the trend of change in prevalence in each category of diseases from 1990 to 2019, stratified by sex and age, for Iran, HMSDI countries, and the world. RESULTS In 2019, refractive errors and cataracts were the most common causes of blindness and VI for both genders in Iran, HMSDI countries and the world. Iran had a higher age-standardized prevalence in all four categories of ophthalmologic disorders compared to HMSDI countries and the world for both genders in 2019. Additionally, the age-specific prevalence of all four disorders in 2019 was higher in Iran compared to HMSDI countries. However, in terms of trends of prevalence from 1990 to 2019, the rate of reduction for the four ophthalmologic disorders in Iran was higher than in HMSDI and the world for both males and females. Furthermore, Iran had a greater percentage of reduction in prevalence for all age groups in all four disorders compared to HMSDI countries. CONCLUSION The prevalence of cataracts, refractive errors, AMD, and glaucoma in Iran was higher compared to HMSDI countries in 2019 for both sexes and all age groups, but the trends of prevalence for all four disorders from 1990 to 2019 in Iran had a higher slope of reduction compared to HMSDI countries for all ages and sexes.
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Affiliation(s)
- Kiana Khatami
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - AliReza Estedlal
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - AliReza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Mahmood Nejabat
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- MD-MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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3
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Bahremani E, Alizadeh M, Nejadghaderi SA, Noori M, Sullman MJM, Kolahi AA, Safiri S. The burden of vision loss in the Middle East and North Africa region, 1990-2019. Arch Public Health 2023; 81:172. [PMID: 37749704 PMCID: PMC10521494 DOI: 10.1186/s13690-023-01188-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The loss of vision is a substantial public health concern that has important implications for an individual's quality of life. The primary objective of this research was to document the burden of vision loss in the Middle East and North Africa (MENA) region, spanning the years 1990-2019, by age group, sex, underlying cause and sociodemographic index (SDI). METHODS Publicly available data concerning the burden of vision loss were acquired from the Global Burden of Disease study 2019. The data encompassed all 21 countries within the MENA region for the period spanning 1990 to 2019. The estimates were reported as raw counts and age-standardised rates per 100,000, accompanied by their corresponding 95% uncertainty intervals (UIs). RESULTS In 2019, MENA had an age-standardised point prevalence of 7040.0 (95% UI: 6195.0, 8002.7) and an YLD rate of 314.5 (222.1, 427.6) per 100,000 for vision loss, which were 11.1% (-12.5, -9.7) and 24.3% (-27.6, -20.8) lower, respectively, than in 1990. In 2019, Afghanistan [469.6 (333.0, 632.8)] had the largest age-standardised YLD rate and Turkey [210.7 (145.3, 290.9)] had the lowest. All countries showed a decrease in the age-standardised point prevalence and YLD rate between 1990 and 2019, except for Oman, Afghanistan, and Yemen. Furthermore, in 2019 the largest number of prevalent cases and YLDs were found in the 65-69 age group. Also in 2019, the age-standardised YLD rates in MENA exceeded the global averages for most age groups, for both males and females. In 2019, refractive disorders were the most common types of vision loss among children, adolescents, and middle-age adults in MENA, while near vision loss and cataracts were the most common among older adults. Finally, the burden of vision loss had a slightly negatively association with SDI over the period 1990-2019. CONCLUSION Although the burden of vision loss has decreased over the last three decades, the prevalence remains high. These results underscore the importance of healthcare policymakers taking action to implement preventive measures, especially among the elderly and those living in low socioeconomic countries, to decrease the attributable burden in MENA.
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Affiliation(s)
- Erfan Bahremani
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Ophthalmology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahasti Alizadeh
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
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4
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Neale RE, Lucas RM, Byrne SN, Hollestein L, Rhodes LE, Yazar S, Young AR, Berwick M, Ireland RA, Olsen CM. The effects of exposure to solar radiation on human health. Photochem Photobiol Sci 2023:10.1007/s43630-023-00375-8. [PMID: 36856971 PMCID: PMC9976694 DOI: 10.1007/s43630-023-00375-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 03/02/2023]
Abstract
This assessment by the Environmental Effects Assessment Panel (EEAP) of the Montreal Protocol under the United Nations Environment Programme (UNEP) evaluates the effects of ultraviolet (UV) radiation on human health within the context of the Montreal Protocol and its Amendments. We assess work published since our last comprehensive assessment in 2018. Over the last four years gains have been made in knowledge of the links between sun exposure and health outcomes, mechanisms, and estimates of disease burden, including economic impacts. Of particular note, there is new information about the way in which exposure to UV radiation modulates the immune system, causing both harms and benefits for health. The burden of skin cancer remains high, with many lives lost to melanoma and many more people treated for keratinocyte cancer, but it has been estimated that the Montreal Protocol will prevent 11 million cases of melanoma and 432 million cases of keratinocyte cancer that would otherwise have occurred in the United States in people born between 1890 and 2100. While the incidence of skin cancer continues to rise, rates have stabilised in younger populations in some countries. Mortality has also plateaued, partly due to the use of systemic therapies for advanced disease. However, these therapies are very expensive, contributing to the extremely high economic burden of skin cancer, and emphasising the importance and comparative cost-effectiveness of prevention. Photodermatoses, inflammatory skin conditions induced by exposure to UV radiation, can have a marked detrimental impact on the quality of life of sufferers. More information is emerging about their potential link with commonly used drugs, particularly anti-hypertensives. The eyes are also harmed by over-exposure to UV radiation. The incidence of cataract and pterygium is continuing to rise, and there is now evidence of a link between intraocular melanoma and sun exposure. It has been estimated that the Montreal Protocol will prevent 63 million cases of cataract that would otherwise have occurred in the United States in people born between 1890 and 2100. Despite the clearly established harms, exposure to UV radiation also has benefits for human health. While the best recognised benefit is production of vitamin D, beneficial effects mediated by factors other than vitamin D are emerging. For both sun exposure and vitamin D, there is increasingly convincing evidence of a positive role in diseases related to immune function, including both autoimmune diseases and infection. With its influence on the intensity of UV radiation and global warming, the Montreal Protocol has, and will have, both direct and indirect effects on human health, potentially changing the balance of the risks and benefits of spending time outdoors.
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Affiliation(s)
- R. E. Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia ,School of Public Health, University of Queensland, Brisbane, QLD Australia
| | - R. M. Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT Australia
| | - S. N. Byrne
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - L. Hollestein
- Erasmus MC Cancer Institute, Rotterdam, The Netherlands ,Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - L. E. Rhodes
- Dermatology Research Centre, School of Biological Sciences, University of Manchester, Salford Royal Hospital, Northern Care Alliance NHS Trust, Manchester, UK
| | - S. Yazar
- Garvan Medical Research Institute, Sydney, NSW Australia
| | | | - M. Berwick
- University of New Mexico Comprehensive Cancer Center, Albuquerque, USA
| | - R. A. Ireland
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - C. M. Olsen
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia ,Frazer Institute, University of Queensland, Brisbane, QLD Australia
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Trone MC, Poinard S, Crouzet E, Garcin T, Mentek M, Forest F, Matray M, Thuret G, Gain P. Dropless penetrating keratoplasty using a subconjunctival dexamethasone implant: safety pilot study. Br J Ophthalmol 2023; 107:181-186. [PMID: 34426402 DOI: 10.1136/bjophthalmol-2021-319376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/08/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND/AIM Rejection is the main cause of graft failure after penetrating keratoplasty (PK). Its prevention by repeated instillation of steroid eye-drops has not evolved in decades. Poor adherence and discontinuous nature of eye-drop treatment may explain some PK failures. In a rabbit model, we previously demonstrated that a subconjunctival dexamethasone implant was well tolerated and prevented rejection efficiently in the first 5-6 weeks. This clinical trial investigates its tolerance and safety after PK. METHODS Single-centre, phase II non-randomised tolerance and safety pilot study (NCT02834260). Designed to analyse the risk of elevated intraocular pressure (IOP), discomfort and resorption time. Fourteen patients with a low rejection risk indication of PK were enrolled between January 2017 and August 2018. The implant was injected in the 12 o'clock position, 5 mm from the limbus, at the end of PK. A steroid eye-drop treatment was planned when implant resorption was complete. Patients were monitored regularly for 12 months: IOP (main outcome measure at 1 month), discomfort and redness scores, implant status, rejection episode and central corneal thickness by optical coherence tomography. An independent data safety monitoring committee verified safety aspects. RESULTS No increase in IOP or other adverse event related to the implant was observed. Average resorption time was 6 weeks. The switch to steroid eye-drops was uneventful. One patient, included despite preoperative corneal neovascularisation (unintended protocol deviation) experienced a rejection. CONCLUSIONS This is the first proof of concept that dropless immunosuppression is possible after low rejection risk PK. TRIAL REGISTRATION NUMBER NCT02834260.
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Affiliation(s)
- Marie Caroline Trone
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France.,Ophthalmology Department, University Hospital, Saint-Etienne, France
| | - Sylvain Poinard
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France.,Ophthalmology Department, University Hospital, Saint-Etienne, France
| | - Emmanuel Crouzet
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France
| | - Thibaud Garcin
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France.,Ophthalmology Department, University Hospital, Saint-Etienne, France
| | - Marielle Mentek
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France
| | - Fabien Forest
- Pathology department, University Hospital, Saint-Etienne, France
| | - Marie Matray
- Ophthalmology Department, University Hospital, Saint-Etienne, France
| | - Gilles Thuret
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France .,Ophthalmology Department, University Hospital, Saint-Etienne, France
| | - Philippe Gain
- Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Faculty of Medecine, Jean Monnet University, Saint-Etienne, France.,Ophthalmology Department, University Hospital, Saint-Etienne, France
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Bouzidi A, Charoute H, Charif M, Amalou G, Kandil M, Barakat A, Lenaers G. Clinical and genetic spectrums of 413 North African families with inherited retinal dystrophies and optic neuropathies. Orphanet J Rare Dis 2022; 17:197. [PMID: 35551639 PMCID: PMC9097391 DOI: 10.1186/s13023-022-02340-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background Inherited retinal dystrophies (IRD) and optic neuropathies (ION) are the two major causes world-wide of early visual impairment, frequently leading to legal blindness. These two groups of pathologies are highly heterogeneous and require combined clinical and molecular diagnoses to be securely identified. Exact epidemiological studies are lacking in North Africa, and genetic studies of IRD and ION individuals are often limited to case reports or to some families that migrated to the rest of the world. In order to improve the knowledge of their clinical and genetic spectrums in North Africa, we reviewed published data, to illustrate the most prevalent pathologies, genes and mutations encountered in this geographical region, extending from Morocco to Egypt, comprising 200 million inhabitants. Main body We compiled data from 413 families with IRD or ION together with their available molecular diagnosis. The proportion of IRD represents 82.8% of index cases, while ION accounted for 17.8%. Non-syndromic IRD were more frequent than syndromic ones, with photoreceptor alterations being the main cause of non-syndromic IRD, represented by retinitis pigmentosa, Leber congenital amaurosis, and cone-rod dystrophies, while ciliopathies constitute the major part of syndromic-IRD, in which the Usher and Bardet Biedl syndromes occupy 41.2% and 31.1%, respectively. We identified 71 ION families, 84.5% with a syndromic presentation, while surprisingly, non-syndromic ION are scarcely reported, with only 11 families with autosomal recessive optic atrophies related to OPA7 and OPA10 variants, or with the mitochondrial related Leber ION. Overall, consanguinity is a major cause of these diseases within North African countries, as 76.1% of IRD and 78.8% of ION investigated families were consanguineous, explaining the high rate of autosomal recessive inheritance pattern compared to the dominant one. In addition, we identified many founder mutations in small endogamous communities. Short conclusion As both IRD and ION diseases constitute a real public health burden, their under-diagnosis in North Africa due to the absence of physicians trained to the identification of inherited ophthalmologic presentations, together with the scarcity of tools for the molecular diagnosis represent major political, economic and health challenges for the future, to first establish accurate clinical diagnoses and then treat patients with the emergent therapies. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02340-7.
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Affiliation(s)
- Aymane Bouzidi
- Equipe MitoLab, Unité MitoVasc, INSERM U1083, CHU d'Angers, CNRS 6015, Université d'Angers, 49933, Angers, France.,Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco.,Team of Anthropogenetics and Biotechnologies, Faculty of Sciences, Chouaïb Doukkali University, Eljadida, Morocco
| | - Hicham Charoute
- Research Unit of Epidemiology, Biostatistics and Bioinformatics, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Majida Charif
- Genetics, and Immuno-Cell Therapy Team, Mohamed First University, Oujda, Morocco
| | - Ghita Amalou
- Equipe MitoLab, Unité MitoVasc, INSERM U1083, CHU d'Angers, CNRS 6015, Université d'Angers, 49933, Angers, France.,Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco.,Team of Anthropogenetics and Biotechnologies, Faculty of Sciences, Chouaïb Doukkali University, Eljadida, Morocco
| | - Mostafa Kandil
- Team of Anthropogenetics and Biotechnologies, Faculty of Sciences, Chouaïb Doukkali University, Eljadida, Morocco
| | - Abdelhamid Barakat
- Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Guy Lenaers
- Equipe MitoLab, Unité MitoVasc, INSERM U1083, CHU d'Angers, CNRS 6015, Université d'Angers, 49933, Angers, France. .,Service de Neurologie, CHU d'Angers, Angers, France.
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7
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Okasheh-Otoom A, Gammoh Y, Otoum M, Naqaweh A. The Scope of Optometry Practice in Jordan. Optom Vis Sci 2022; 99:35-44. [PMID: 34882601 DOI: 10.1097/opx.0000000000001823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The scope of optometry practice varies worldwide. Although the scope of optometry practice in Jordan is regulated, discrepancies exist in the services that optometry professionals provide. PURPOSE This study aimed to document the scope of optometry practice in Jordan and to describe the services that optometry professionals provide, as well as to inform regulatory bodies and educators about the current situation of optometry practice and areas that require development. METHODS A cross-sectional study was conducted using a questionnaire completed by optometry professionals working across Jordan. The questionnaire items cover the services and the tests they perform. RESULTS Of the 714 participants, 57.8% were female and 42.2% were male, with a median age of 29 years. Participants were unevenly distributed across Jordan, with the majority working in the major cities and at optical centers (81.5%). Most participants were described as "refractionists." The most frequently provided services were basic optometric examinations, followed by community eye care services. Ocular medications were not prescribed by any participant. Reasons for not providing services were mainly attributed to license/profession regulations constraints and the service(s) not being part of the job description. About one-half of the participants have the knowledge to diagnose adnexal and anterior segment disorders. CONCLUSIONS Optometry professionals in Jordan can provide more services if the scope of practice is expanded to match their knowledge and skills. Moreover, their nomenclature as refractionists does not represent the range of services they provide that extend beyond refraction. The concern is that optometric services are not reachable by many Jordanian populations because of the inequality of the distribution of professionals. Thus, advocacy to expand the scope of practice in Jordan is recommended.
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Affiliation(s)
| | - Yazan Gammoh
- Department of Optometry Science, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | | | - Abdullah Naqaweh
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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8
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Zabsonré/Ahnoux A, Traoré A, Diallo JW, Koussé S, Sanou J, Meda N. [Overview of visual impairment at the Yalgado Ouédraogo University Medical Center: Study of 501 cases]. J Fr Ophtalmol 2021; 45:28-33. [PMID: 34922778 DOI: 10.1016/j.jfo.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the main causes of visual impairment according to age in patients admitted to the ophthalmology department. MATERIALS AND METHODS This was a retrospective study of 501 cases of visual impairment. Included were patients of both sexes whose best-corrected visual acuity in the better eye was strictly less than 5/10. The parameters studied were age, gender, place of residence, corrected visual acuity in the better eye, and diagnosis. The data were entered and processed with the Epi info 7.2 software. RESULTS Subjects over 50 were the most prevalent (48.5%). In patients over 50 years of age, cataracts (54.32%) were the leading cause of visual impairment, followed by glaucoma (24.69%) and non-glaucomatous optic neuropathy (26.19%). Trauma (17.62%) was frequently found in patients aged 16 to 50 years. Tropical endemic limbo-conjunctivitis (25.00%) was the leading cause of visual impairment in subjects aged 5 to 15 years. CONCLUSION This study confirms the results of the literature, which have shown that cataracts are the leading cause of visual impairment in developing countries. A major effort to raise awareness, provide information and therapeutic care would reduce the incidence of visual impairment.
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Affiliation(s)
- A Zabsonré/Ahnoux
- Service d'ophtalmologie, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
| | - A Traoré
- Service d'ophtalmologie, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso.
| | - J W Diallo
- Service d'ophtalmologie, CHU Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | - S Koussé
- Service d'ophtalmologie, CHU Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | - J Sanou
- Service d'ophtalmologie, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
| | - N Meda
- Service d'ophtalmologie, CHU Yalgado Ouédraogo, 03 BP 7022, Ouagadougou, Burkina Faso
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9
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Torabi R, Harris A, Siesky B, Zukerman R, Oddone F, Mathew S, Januleviciene I, Vercellin ACV. Prevalence Rates and Risk Factors for Primary Open Angle Glaucoma in the Middle East. J Ophthalmic Vis Res 2021; 16:644-656. [PMID: 34840687 PMCID: PMC8593541 DOI: 10.18502/jovr.v16i4.9755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022] Open
Abstract
Glaucoma is a multifactorial disease and a leading cause of irreversible blindness worldwide. Current data has demonstrated the approximate distribution of primary open-angle glaucoma (POAG) in patients of European, African, Hispanic, and Eastern Asian descent. However, a significant gap in the literature exists regarding the prevalence of POAG in Middle Eastern (ME) populations. Current studies estimate ME POAG prevalence based on a European model. Herein we screened 65 total publications on ME prevalence of POAG and specific risk factors using keywords: "glaucoma", "prevalence", "incidence", "risk factor", "Middle East", "Mideast", "Persian", "Far East", as well as searching by individual ME countries through PubMed, Embase, Ovid, Scopus, and Trip searches with additional reference list searches from relevant articles published up to and including March 1, 2021. Fifty qualifying records were included after 15 studies identified with low statistical power, confounding co-morbid ophthalmic diseases, and funding bias were excluded. Studies of ME glaucoma risk factors that identify chromosomes, familial trend, age/gender, socioeconomic status, lifestyle, intraocular pressure, vascular influences, optic disc hemorrhage, cup-to-disc ratio, blood pressure, obstructive sleep apnea, and diabetes mellitus were included in this systematic review. We conclude that the prevalence of POAG in the ME is likely higher than the prevalence rate that European models suggest, with ME specific risk factors likely playing a role. However, these findings are severely limited by the paucity of population-level data in the ME. Well-designed, longitudinal population-based studies with rigorous inclusion and exclusion criteria are ultimately needed to accurately assess the epidemiology and specific mechanistic risk factors of glaucoma in ME populations.
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Affiliation(s)
- Rana Torabi
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brent Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Zukerman
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Sunu Mathew
- Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology, Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Ingrida Januleviciene
- Eye Clinic of Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
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Siesky B, Harris A, Vercellin ACV, Guidoboni G, Tsai JC. Ocular blood flow as it relates to race and disease on glaucoma. ADVANCES IN OPHTHALMOLOGY AND OPTOMETRY 2021; 6:245-262. [PMID: 35252630 PMCID: PMC8896810 DOI: 10.1016/j.yaoo.2021.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Glaucoma is a multifactorial progressive and degenerative optic neuropathy representing one of the world's leading cause of irreversible blindness. Currently, reduction of intraocular pressure remains the only universally approved therapy, yet a wealth of studies has identified significant vascular contributions to the disease process in certain individuals. Population-based studies have identified important racial disparities and differential risk factors in glaucoma prevalence, incidence, and progression. A more significant vascular component has been identified in persons of African descent. Elucidating risk modifiers, including genetic and racial influence, is important when considering individually tailored clinical management of glaucoma. The application of artificial intelligence and mathematical modeling inclusive of demographic considerations, vascular health, and clinical biomarkers may help reduce disease disparities, advance personalized medicine, and provide a comprehensive model of glaucoma.
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Affiliation(s)
- Brent Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Alon Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Alice C. Verticchio Vercellin
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Ophthalmology, University of Pavia, Pavia, Italy
- IRCCS - Fondazione Bietti, Rome, Italy
| | - Giovanna Guidoboni
- Department of Electrical Engineering and Computer Science, Department of Mathematics, University of Missouri, Columbia, MO, United States
| | - James C. Tsai
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
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11
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Neale RE, Barnes PW, Robson TM, Neale PJ, Williamson CE, Zepp RG, Wilson SR, Madronich S, Andrady AL, Heikkilä AM, Bernhard GH, Bais AF, Aucamp PJ, Banaszak AT, Bornman JF, Bruckman LS, Byrne SN, Foereid B, Häder DP, Hollestein LM, Hou WC, Hylander S, Jansen MAK, Klekociuk AR, Liley JB, Longstreth J, Lucas RM, Martinez-Abaigar J, McNeill K, Olsen CM, Pandey KK, Rhodes LE, Robinson SA, Rose KC, Schikowski T, Solomon KR, Sulzberger B, Ukpebor JE, Wang QW, Wängberg SÅ, White CC, Yazar S, Young AR, Young PJ, Zhu L, Zhu M. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020. Photochem Photobiol Sci 2021; 20:1-67. [PMID: 33721243 PMCID: PMC7816068 DOI: 10.1007/s43630-020-00001-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 01/31/2023]
Abstract
This assessment by the Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme (UNEP) provides the latest scientific update since our most recent comprehensive assessment (Photochemical and Photobiological Sciences, 2019, 18, 595-828). The interactive effects between the stratospheric ozone layer, solar ultraviolet (UV) radiation, and climate change are presented within the framework of the Montreal Protocol and the United Nations Sustainable Development Goals. We address how these global environmental changes affect the atmosphere and air quality; human health; terrestrial and aquatic ecosystems; biogeochemical cycles; and materials used in outdoor construction, solar energy technologies, and fabrics. In many cases, there is a growing influence from changes in seasonality and extreme events due to climate change. Additionally, we assess the transmission and environmental effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the COVID-19 pandemic, in the context of linkages with solar UV radiation and the Montreal Protocol.
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Affiliation(s)
- R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P W Barnes
- Biological Sciences and Environmental Program, Loyola University New Orleans, New Orleans, LA, USA
| | - T M Robson
- Organismal and Evolutionary Biology (OEB), Viikki Plant Sciences Centre (ViPS), University of Helsinki, Helsinki, Finland
| | - P J Neale
- Smithsonian Environmental Research Center, Maryland, USA
| | - C E Williamson
- Department of Biology, Miami University, Oxford, OH, USA
| | - R G Zepp
- ORD/CEMM, US Environmental Protection Agency, Athens, GA, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - S Madronich
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - A L Andrady
- Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC, USA
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - G H Bernhard
- Biospherical Instruments Inc, San Diego, CA, USA
| | - A F Bais
- Department of Physics, Laboratory of Atmospheric Physics, Aristotle University, Thessaloniki, Greece
| | - P J Aucamp
- Ptersa Environmental Consultants, Pretoria, South Africa
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Universidad Nacional Autónoma de México, Puerto Morelos, México
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | - L S Bruckman
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - S N Byrne
- The University of Sydney, School of Medical Sciences, Discipline of Applied Medical Science, Sydney, Australia
| | - B Foereid
- Environment and Natural Resources, Norwegian Institute of Bioeconomy Research, Ås, Norway
| | - D-P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - L M Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - W-C Hou
- Department of Environmental Engineering, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - S Hylander
- Centre for Ecology and Evolution in Microbial model Systems-EEMiS, Linnaeus University, Kalmar, Sweden.
| | - M A K Jansen
- School of BEES, Environmental Research Institute, University College Cork, Cork, Ireland
| | - A R Klekociuk
- Antarctic Climate Program, Australian Antarctic Division, Kingston, Australia
| | - J B Liley
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - J Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, MD, USA
| | - R M Lucas
- National Centre of Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - J Martinez-Abaigar
- Faculty of Science and Technology, University of La Rioja, Logroño, Spain
| | | | - C M Olsen
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - K K Pandey
- Department of Wood Properties and Uses, Institute of Wood Science and Technology, Bangalore, India
| | - L E Rhodes
- Photobiology Unit, Dermatology Research Centre, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - S A Robinson
- Securing Antarctica's Environmental Future, Global Challenges Program and School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - T Schikowski
- IUF-Leibniz Institute of Environmental Medicine, Dusseldorf, Germany
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - B Sulzberger
- Academic Guest Eawag: Swiss Federal Institute of Aquatic Science and Technology, Duebendorf, Switzerland
| | - J E Ukpebor
- Chemistry Department, Faculty of Physical Sciences, University of Benin, Benin City, Nigeria
| | - Q-W Wang
- Institute of Applied Ecology, Chinese Academy of Sciences (CAS), Shenyang, China
| | - S-Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - C C White
- Bee America, 5409 Mohican Rd, Bethesda, MD, USA
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, UK
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - L Zhu
- Center for Advanced Low-Dimension Materials, Donghua University, Shanghai, China
| | - M Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China
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12
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Prevalence and causes of vision impairment and blindness in the Russian ural eye and medical study. Sci Rep 2020; 10:12397. [PMID: 32709931 PMCID: PMC7381659 DOI: 10.1038/s41598-020-69439-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/01/2020] [Indexed: 11/24/2022] Open
Abstract
To assess prevalence of mild vision impairment (MVI; best corrected visual acuity (BCVA) < 6/12 to 6/18 in the better eye), moderate-to-severe vision impairment (MSVI; BCVA < 6/18 but ≥ 3/60) and blindness (BCVA < 3/60) in a local population in Russia, we conducted the population-based Ural Eye and Medical Study. Out of 7,328 eligible individuals aged 40 + years, 5,899 (80.5%) individuals participated. MVI was present in 184 (3.1%; 95% confidence interval (CI) 2.7, 3.6) individuals, MSVI in 182 (3.1%; 95% CI 2.7, 3.5) individuals, and 11 individuals (0.19%; 95% CI 0.008, 0.30) were blind. Causes for MSVI were cataract (n = 109; 59.9%), late stage of age-related macular degeneration (n = 14; 7.7%; geographic atrophy and neovascular AMD in 7 (3.8%) individuals) each), myopic maculopathy (n = 11; 6.0%), glaucoma (n = 9; 4.9%), non-glaucomatous optic nerve damage (n = 5; 2.7%), and diabetic retinopathy (n = 4; 2.2%). Causes for blindness were cataract (n = 3; 27.3%), myopic maculopathy (n = 2; 18.2%), retinal dystrophies (n = 2; 18.2%), glaucoma (n = 1; 9.1%), and corneal scars (n = 1; 9.1%). Higher prevalence of MSVI/blindness was associated with age (P < 0.001; odds ratio (OR)1.10; 95% CI 1.08, 1.12), male gender (P < 0.001; OR 2.32; 95% CI 1.47, 3.66), educational level (P < 0.001; OR 0.83; 95% CI 0.76,0.92), manual grip force (P < 0.001; OR 0.94; 95% CI 0.92, 0.96), diabetes prevalence (P = 0.006; OR 1.67; 95% CI 1.08, 2.56) and axial length (P < 0.001; OR 1.43; 95% CI 1.26,1.62). In this population from Bashkortostan/Russia, prevalence of MVI, MSVI and blindness was 3.1%, 3.1% and 0.19%, respectively. Cataract was the most frequent cause of reversible vision impairment, while AMD, myopic maculopathy and glaucoma were the most common reasons for irreversible vision impairment.
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You QS, Choy BKN, Chan JCH, Ng ALK, Shih KC, Cheung JJC, Wong JKW, Shum JWH, Ni MY, Lai JS, Leung GM, Wong TY, Wong IYH. Prevalence and Causes of Visual Impairment and Blindness among Adult Chinese in Hong Kong – The Hong Kong Eye Study. Ophthalmic Epidemiol 2020; 27:354-363. [DOI: 10.1080/09286586.2020.1755444] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Qi Sheng You
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Casey Eye Institute, Oregon Health Science University, Portland, Washington, USA
| | - Bonnie K. N. Choy
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jonathan C. H. Chan
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Alex L. K. Ng
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kendrick C. Shih
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janice J. C. Cheung
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jasper K. W. Wong
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jennifer W. H. Shum
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jimmy Sm Lai
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tien Yin Wong
- Department of Ophthalmology, Singapore National Eye Center, Singapore
| | - Ian Y. H. Wong
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong, China
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Al-Ghamdi AS. Adults visual impairment and blindness - An overview of prevalence and causes in Saudi Arabia. Saudi J Ophthalmol 2019; 33:374-381. [PMID: 31920448 PMCID: PMC6950952 DOI: 10.1016/j.sjopt.2019.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 07/27/2019] [Accepted: 10/07/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND A major socio-economic development in Saudi Arabia affected the pattern and causes of visual impairment for the past 40 years. Moreover, an up-to-date summary of available data is vital for planning, monitoring, and evaluating national blindness prevention program. AIM This study conducted to provide a summary overview of prevalence, causes, and changes in the pattern of blindness and visual impairment for the past 40 years among Saudi adults, with brief discussion of the related socio-economic and ecological factors. METHODS The review was confined to the published epidemiological studies performed in Saudi Arabia covering the age group 18 year and older from 1985 onwards. RESULTS Six epidemiological studies were included from 1985 onwards. In1986, the prevalence of blindness and visual impairment in Saudi Arabia were 1.5% and 7.8%, respectively which is 20 times the magnitude of blindness in the United States. Multiple regional population based studies conducted later in areas with disparate ecological and socio-economical determinants at different time intervals showed variable prevalence of blindness 3.3% Eastern Province 1986, 0.7% Bisha 1993. Recently, in older than 50 year population the reported prevalence was 2.6% Taif 2012 and 5.7% Jazan 2015 and 6.4% in Ahsa. Since 1986, the single leading cause of adult blindness in Saudi Arabia is cataract. Although, Trachoma reported to be the second primary cause of blindness on 1986, its burden is reduced in Jizan (2015) and minimal in Taif (2012) which is replaced by chronic diseases related etiologies i.e Diabetic Retinopathy. CONCLUSION Ecological and socio-economical determinants play critical role in the magnitude and causes of blindness and visual impairment in Saudi Arabia. Significant data gaps obscure monitoring and evaluation of the eye health. Eye health indicators should be integrated into the national health information system for dynamic monitoring and evaluation.
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Hassan B, Ahmed R, Li B, Noor A, Hassan ZU. A comprehensive study capturing vision loss burden in Pakistan (1990-2025): Findings from the Global Burden of Disease (GBD) 2017 study. PLoS One 2019; 14:e0216492. [PMID: 31050688 PMCID: PMC6499467 DOI: 10.1371/journal.pone.0216492] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/22/2019] [Indexed: 11/23/2022] Open
Abstract
This study aims to provide estimates, trends and projections of vision loss burden in Pakistan from 1990 to 2025. Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2017) was used to observe the vision loss burden in terms of prevalence and Years Lived with Disability (YLDs). As of 2017, out of 207.7 million people in Pakistan, an estimated 1.12 million (95% Uncertainty Interval [UI] 1.07–1.19) were blind (Visual Acuity [VA] <3/60), 1.09 million [0.93–1.24] people had severe vision loss (3/60≤VA<6/60) and 6.79 million [6.00–7.74] people had moderate vision loss (6/60≤VA<6/18). Presbyopia was found to be the most common ocular condition that affected an estimated 12.64 million [11.94–13.41] people (crude prevalence 6.08% [5.75–6.45]; 61% female). In terms of age-standardized YLDs rate, Pakistan is ranked fourth among other South Asian countries and twenty-first among other 42 low-middle income countries (classified by World Bank), with 552.98 YLDs [392.98–752.95] per 100,000. Compared with 1990, all-age YLDs count of blindness and vision impairment increased by 55% in 2017, which is the tenth highest increase among major health loss causes (such as dietary iron deficiency, headache disorders, low back pain etc.) in Pakistan. Moreover, our statistics show an increase in vision loss burden by 2025 for which Pakistan needs to make more efforts to encounter the growing burden of eye diseases.
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Affiliation(s)
- Bilal Hassan
- School of Automation Science and Electrical Engineering, Beihang University, Beijing, China
- * E-mail:
| | - Ramsha Ahmed
- School of Computer and Communication Engineering, University of Science & Technology Beijing, Beijing, China
| | - Bo Li
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Ayesha Noor
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Zahid ul Hassan
- Department of Pharmacology, Yusra Medical and Dental College, Islamabad, Pakistan
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