Epidemiological variations and trends in health burden of glaucoma worldwide.

PURPOSE

To evaluate the trends and variations in global health burden of glaucoma by year, age and sex, region and socio-economic status, using disability-adjusted life years (DALYs).

METHOD

The DALY numbers, crude DALY rate and age-standardized DALY rate globally and in each country were obtained the GBD 2015 study database. The corresponding human development index (HDI) and gross domestic product (GDP) per capita were obtained from the United Nations and World Bank. Environmental data were obtained from the WHO Global Health Observatory data repository.

RESULTS

From 1990 to 2015, the DALY number and age-standardized DALY rate due to glaucoma increased by 122% and 15%, respectively. Both male and female showed similar increasing trend with ageing, with the peak at 60 years old and increasing again since 75 years old. Sex disparities in DALY number were noted, with higher burden among female than male in each age group (all p < 0.001). The health burden of glaucoma was substantial unequal, with Gini coefficient of 0.865 for DALY number, 0.235 for crude DALY rate and 0.254 for age-standardized DALY rate, respectively. The age-standardized DALY was significantly associated with HDI, accounting for 22.2% variance across countries (R = 0.222, p < 0.001). Similarly, the GDP per capita was inversely associated with age-standardized DALY rate but can explain only 10.6% variations in age-standardized DALY rate (R = 0.106, p < 0.001). The age-standardized DALY rate due to glaucoma was positively associated with national levels of ultraviolet radiation and PM.

CONCLUSION

The health burden of glaucoma continuously increased in the past 25 years and distributed unequally. Lower socio-economic level, older age, female, higher ambient ultraviolet radiation and higher level of air pollution were significantly associated with higher burden of glaucoma.