Time Trends and Heterogeneity in the Disease Burden of Glaucoma, 1990-2017: A Global Analysis

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-standardised 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-standardised DALY rate and the variables. Findings: 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-standardised DALY rates (P < 0·001). The age-standardised DALY rate was higher in countries with lower income or lower SDI (P < 0·001). Stepwise multiple regressions showed that HDI, cataract surgery rate (CRS), and Inequality-Adjusted HDI were significantly negatively associated with the country-level age-standardised DALY rate in 2017 after adjusting for other confounding factors (P < 0·001). Interpretation: Older age and being male were associated with a higher burden of glaucoma. 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. Funding: National Natural Science Foundation of China (Grant No: 81700833). Declaration of Interest: The authors have no potential conflicts of interest.