Time trends and heterogeneity in the disease burden of glaucoma, 1990-2017: A global analysis

Abstract

Background To evaluate the disease burden of glaucoma in terms of disability- adjusted life years (DALY) and assess the contribution of risk factors to DALY due to glaucoma. Methods Global, regional, and country DALY number, rate, and age-standardized rates of glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), Inequality-Adjusted HDI, Socio-Demographic Index (SDI), and other country-level data were derived from international open databases. Regression analysis was used to assess the correlations between the age-standardized DALY rate and the variables. Results The global DALY due to glaucoma increased by 81% from 1990 to 2017 and decreased by 10% over the last two decades after adjusting for age and population size. Males had higher age-standardized DALY rates (P < 0.001). The age-standardized DALY rate was higher in countries with lower income or lower SDI (P < 0.001). The country-level age-standardized DALY rates in 2017 were negatively associated with HDI, SDI, country-level age-standardized prevalence rates of cataracts, cataract surgery rates (CRS), physician rates, and Inequality-Adjusted HDI. Stepwise multiple regressions showed that HDI, CRS, and Inequality-Adjusted HDI were significantly negatively associated with the country-level age-standardized DALY rate in 2017 after adjusting for other confounding factors (P < 0.001). Conclusions Higher education, higher CRS, and diminishing the inequality in resource distribution may help reduce the disease burden of glaucoma. These findings can provide information for policymakers and could serve as an impetus for efforts toward alleviating the disease burden of glaucoma.