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Zhou C, Li S, Ye L, Chen C, Liu S, Yang H, Zhuang P, Liu Z, Jiang H, Han J, Jiang Y, Zhou L, Zhou X, Xiao J, Zhang C, Wen L, Lan C, Wang Y, Sun T, Jiang L, Xie P, Chen F, Liang G, Fu D, Zhang T, Shi X, Song Z, Liu X, Li S, Li P, Xu X, Wei Q, Wang W, Huang X, De Z, Deng A, Ding L, Pan X, Wen H, Zhang Z, Lv H, Zhang J, Tian X, Deng Z, Wang H, Wang F, Wang Y, Zhao H, Fang Y, Wu Y, Wu Y, Shen N, Li B, Li X, Dai H, Zhao N, Sun X, Zheng Z, Liu K, Xu X. Visual impairment and blindness caused by retinal diseases: A nationwide register-based study. J Glob Health 2023; 13:04126. [PMID: 37921040 PMCID: PMC10623496 DOI: 10.7189/jogh.13.04126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Background Retinal disorders cause substantial visual burden globally. Accurate estimates of the vision loss due to retinal diseases are pivotal to inform optimal eye health care planning and allocation of medical resources. The purpose of this study is to describe the proportion of visual impairment and blindness caused by major retinal diseases in China. Methods A nationwide register-based study of vitreoretinal disease covering all 31 provinces (51 treating centres) of mainland China. A total of 28 320 adults diagnosed with retinal diseases were included. Participants underwent standardised ocular examinations, which included best-corrected visual acuity (BCVA), dilated-fundus assessments, and optical coherence tomography. Visual impairment and blindness are defined using BCVA according to the World Health Organization (WHO) (visual impairment: <20/63-≥20/400; blindness: <20/400) and the United States (visual impairment: <20/40-≥20/200; blindness: <20/200) definitions. The risk factors of vision loss were explored by logistic regression analyses. Results Based on the WHO definitions, the proportions for unilateral visual impairment and blindness were 46% and 18%, respectively, whereas those for bilateral visual impairment and blindness were 31% and 3.3%, respectively. Diabetic retinopathy (DR) accounts for the largest proportion of patients with visual impairment (unilateral visual impairment: 32%, bilateral visual impairment: 60%) and blindness (unilateral blindness: 35%; bilateral blindness: 64%). Other retinal diseases that contributed significantly to vision loss included age-related macular degeneration, myopic maculopathy, retinal vein occlusion, and rhegmatogenous retinal detachment and other macular diseases. Women (bilateral vision loss: P = 0.011), aged patients (unilateral vision loss: 45-64 years: P < 0.001, ≥65 years: P < 0.001; bilateral vision loss: 45-64 years: P = 0.003, ≥65 years: P < 0.001 (reference: 18-44 years)) and those from Midwest China (unilateral and bilateral vision loss: both P < 0.001) were more likely to suffer from vision loss. Conclusions Retinal disorders cause substantial visual burden among patients with retinal diseases in China. DR, the predominant retinal disease, is accountable for the most prevalent visual disabilities. Better control of diabetes and scaled-up screenings are warranted to prevent DR. Specific attention should be paid to women, aged patients, and less developed regions.
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Affiliation(s)
- Chuandi Zhou
- Department 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
| | - Shu Li
- Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luyao Ye
- Department 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
| | - Chong Chen
- Department 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
| | - Shu Liu
- Department of Ophthalmology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong Province, China
| | - Hongxia Yang
- Department of Ophthalmology, The First People's Hospital of Jinzhong, Jinzhong, Liaoning Province, China
| | - Peng Zhuang
- Department of Ophthalmology, Zhangzhou Municipal Hospital of Fujian Province, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China
| | - Zengye Liu
- Department of Ophthalmology, Tianjin First Central Hospital, Tianjin, China
| | - Hongwen Jiang
- Department of Ophthalmology, The First People's Hospital of Kashgar, Kashgar, Xinjiang Uighur Autonomous Region, China
| | - Jing Han
- Department of Ophthalmology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shanxi Province, China
| | - Yiping Jiang
- Department of Ophthalmology, The First Affiliated Hospital of Gannan Medical University, Gannan, Jiangxi Province, China
| | - Liqin Zhou
- Department of Ophthalmology, The First Hospital of Jiaxing, Affiliatd Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
| | - Xiyuan Zhou
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Xiao
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Cangxia Zhang
- Department of Ophthalmology, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, Hebei Province, China
| | - Lihui Wen
- Department of Ophthalmology, The Second People's Hospital of Guilin, Guilin, Guangxi Province, China
| | - Changjun Lan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Yuqing Wang
- Department of Ophthalmology, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, China
| | - Tao Sun
- Department of Ophthalmology, Yancheng City No. 1 People's Hospital, Yancheng, Jiangsu Province, China
| | - Li Jiang
- Department of Ophthalmology, Benxi Central Hospital, Benxi, Liaoning Province, China
| | - Peipei Xie
- Department of Ophthalmology, The 152th Central Hospital of the People's Liberation Army, Pingdingshan, Henan Province, China
| | - Fan Chen
- Department of Ophthalmology, Anqing Municipal Hospital, Anqing, Anhui Province, China
| | - Ge Liang
- Department of Ophthalmology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Dongdong Fu
- Department of Ophthalmology, People's Hospital of Zunyi City Bo Zhou District, Zunyi, Guzhou Province, China
| | - Tianzi Zhang
- Department of Ophthalmology, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia Autonomous Region, China
| | - Xuetao Shi
- Department of Ophthalmology, Pu’er City People's Hospital, Pu’er, Yunnan Province, China
| | - Zhengyu Song
- Department of Ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xinghong Liu
- Department of Ophthalmology, The Central Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Shanshan Li
- Department of Ophthalmology, Workers' Hospital of Jinchuan Group Co., Ltd, Jinchang, Gansu Province, China
| | - Pengcheng Li
- Department of Ophthalmology, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiangzhou Xu
- Department of Ophthalmology, Huizhou First Hospital, Huizhou, Guangdong Province, China
| | - Qinfeng Wei
- Department of Ophthalmology, The Second People's Hospital of Xining, Xining, Qinghai Province, China
| | - Weibang Wang
- Department of Ophthalmology, The First People's Hospital of Yinchuan, The Second Affiliated Hospital of Ningxia Medical School, Yinchuan, Ningxia Hui autonomous region, China
| | - Xionggao Huang
- Department of Ophthalmology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
| | - Zhen De
- Department of Ophthalmology, Shigatse People's Hospital, Shigatse, Tibet Autonomous Region, China
| | - Aijun Deng
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical School, Weifang, Shandong Province, China
| | - Lin Ding
- Department of Ophthalmology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Xiuhong Pan
- Yuncheng Eye Hospital, Yuncheng, Shanxi Province, China
| | - Haiyan Wen
- Department of Ophthalmology, People's Hospital of Jilin City, Jilin, Jilin Province, China
| | - Zhongchen Zhang
- Department of Ophthalmology, Hebei Yanda Hospital, Langfang, Hebei Province, China
| | - Hongbin Lv
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Jian Zhang
- Department of Ophthalmology, Shaanxi Provincial People's Hospital, Xi’an, Shanxi Province, China
| | - Xuemin Tian
- Department of Ophthalmology, The 988th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Kaifeng, Henan Province, China
| | - Zhen Deng
- Department of Ophthalmology, The First People's Hospital of Linping District, Hangzhou, Zhejiang Province, China
| | - Hua Wang
- Department of Ophthalmology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, China
| | - Fang Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China
| | - Yu Wang
- Fushun Ophthalmopathy Hospital, Fushun, Liaoning Province, China
| | - Hongchao Zhao
- Department of Ophthalmology, People's Hospital of Yuxi City, Yuxi, Yunnan Province, China
| | - Yanhong Fang
- Department of Ophthalmology, Jiangjin Central Hospital, Chongqing, China
| | - Yuyu Wu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
| | - Yufeng Wu
- Department of Ophthalmology, Qingyang People's Hospital, Qingyang, Gansu Province, China
| | - Nian Shen
- Department of Ophthalmology, Liuzhou People's Hospital, Liuzhou, Guangxi Zhuang Autonomous Region, China
| | - Bo Li
- Department 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
| | - Xiaorong Li
- Department of Ophthalmology, Tianjin Medical University Eye Hospital, School of Optometry & Eye Institute, Tianjin, China
| | - Hong Dai
- Department of Ophthalmology, Beijing Hospital, Beijing, China
| | - Naiqing Zhao
- Department of Biostatistics, Fudan University School of Public Health, Shanghai, China
| | - Xiaodong Sun
- Department 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
| | - Zhi Zheng
- Department 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
| | - Kun Liu
- Department 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
| | - Xun Xu
- Department 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
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