Global Burden of Cataract and Its Association With Socioeconomic Development Status, 1990-2019

Background: Cataract is the leading cause of blindness globally and more people will be at risk for this common cause of vision loss in the coming years. Our aim is to estimate the disease burden of cataract and evaluate contributions of various risk factors to cataract-associated disability-adjusted life years (DALYs). Methods: Prevalence of visual impairment due to cataract and disability-adjusted life years of cataract were extracted from the Global Burden of Disease (GBD) study 2019 to explore time trends and annual changes. Regional and country-level socioeconomic indexes were acquired from open databases, and stepwise multiple linear regression was used to evaluate associations between age-standardized rate of DALYs of cataract and potential predictors. Findings: Global Prevalence rate of visual impairment due to cataract rose by 58.45% from 791.4 per 100,000 population (95%CI: 705.2 to 890.0 per 100,000 population) to 1253.9 per 100,000 population 95%CI: 1103.3 to 1417.7 per 100,000 population) in 2019 and DALYs rate of cataract rose by 32.18% from 65.3 per 100,000 population (95%CI: 46.4 to 88.2 per 100,000 population) in 1990 to 86.3 per 100,000 population (95%CI: 61.5 to 116.4 per 100,000 population) in 2019. Stepwise multiple linear regression model showed that higher refractive error prevalence (β=0.036, 95% CI: 0.022, 0.050, P <0.001), lower number of physicians per 10,000 population (β=-0.959, 95% CI: -1.685, -0.233, P =0.010) and lower level of HDI (β=-134.93, 95% CI: -209.84, -60.02, P =0.001) were associated with higher disease burden of cataract. Interpretation: Substantial increases in the prevalence of visual impairment and DALYs of cataract were observed from 1990 to 2019. Successful global initiatives targeting improving cataract surgical rate and quality, especially in regions with lower socioeconomic status, is a prerequisite to combating this growing burden of cataract in the aging society. Funding: This work was supported by National Natural Science Foundation of China (81873673, 81900841). X.H. receives support from the China Postdoctoral Science Foundation (2019TQ0365). Declaration of Interest: None to declare.