Global, regional, and national burden of low vision and blindness due to glaucoma, 1990–2021, and projections to 2050: a systematic analysis of glaucoma

BACKGROUND: Glaucoma is the primary cause of irreversible vision impairment worldwide. This study sought to examine epidemiological trends associated with the burden of low vision and blindness attributable to glaucoma from 1990 to 2021, with projections extending to 2050. METHODS: The data utilized in this analysis were derived from the Global Burden of Disease 2021 (GBD 2021) study, encompassing 204 countries and regions. The burden of blindness and low vision attributable to glaucoma is evaluated through several metrics, including the number of cases, age-standardized prevalence rate (ASPR, per 100 000 individuals), annual disability-adjusted life years (DALYs), age-standardized DALY rate (ASDR), and their estimated annual percentage changes (EAPC). Projections of future prevalence trends were generated using the Bayesian age-period-cohort (BAPC) model. RESULTS: In 2021, there was a substantial increase in the global number of glaucoma prevalent cases and DALYs compared with 1990. However, both the ASPR and ASDR exhibited a declining trend [EAPC: -0.73, 95% confidence interval (CI): -0.78 to -0.68; EAPC: - 1.23, 95% CI: -1.27 to -1.19]. Research indicates that the primary factors contributing to the increase in global glaucoma cases over the past three decades are population aging and growth. Conversely, the timely implementation of screening and diagnostic procedures, advancements in treatment methods, and formulation of relevant policies have alleviated the burden of low vision and blindness caused by glaucoma over time. Notable regional disparities exist, with African nations experiencing a particularly high disease burden in 2021, especially in Western sub-Saharan Africa [ASPR: 294.35, 95% uncertainty interval (UI): 250.83-345.34; ASDR: 32.48, 95% UI: 22.35-44.53]. The burden of glaucoma-related low vision and blindness escalates with age, disproportionately affecting the elderly population. Furthermore, men have a higher prevalence and greater disease burden than women do. Projections using the BAPC model suggest that by 2050, the number of cases of low vision and blindness due to glaucoma will reach 11 788 700, with 1 189 269 DALYs. CONCLUSIONS: The global burden of low vision and blindness attributable to glaucoma continues to be a significant concern, necessitating urgent implementation of more effective prevention and treatment strategies to address the challenges associated with glaucoma-related visual impairment in the future.