The burden of vision loss due to Diabetic Retinopathy in Asia from 1990-2021

Background and Objectives: Diabetic Retinopathy (DR) has become the leading cause of vision impairment (VI) worldwide. Leveraging the most recent data and analytical techniques from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced comprehensive estimates of VI due to DR in Asia. These estimates were segmented by location, age, and gender for the period between 1990 and 2021. Furthermore, we projected the burden of DR up to 2050. Methods: We analyzed data from the GBD 2021 to assess the prevalence and Years Lived with Disability (YLDs) due to DR in Asia, examining age structure, trends over time, and gender differences. The study included an analysis of DR-induced VI severity across Asian countries. The Estimated Annual Percentage Change (EAPC) was calculated to illustrate trends at regional and national levels. Bayesian age-period-cohort (BAPC) analysis was used to project future prevalence trends up to 2050. Results: 从 1990 年到 2021 年，亚洲 DR 的年龄标准化患病率 （ASR） 和 YLD 率显著增加，女性的患病率始终较高。老年人承受的负担更大，VI 和 YLDs 的发生率随着年龄的增长而增加。中度视力障碍 （MVI） 构成了亚洲 DR 相关 ASR 的大部分。亚洲国家 DR 负担存在显著差异。2021 年，毛里求斯、塞舌尔、马来西亚和文莱的 ASR 最高，而孟加拉国、不丹、蒙古和日本的 ASR 最低。柬埔寨的增长最快，而新加坡和巴基斯坦则出现下降。大多数亚洲国家的社会人口指数 （SDI） 处于中低水平，相应的 ASR 也很低。根据 BAPC 的预测，到 2050 年，亚洲男性 DR 的 YLD 率将降至 3.92 和女性 4.96。 结论： 在过去的 30 年里，亚洲的 DR 负担有所增加，各国之间持续存在性别差异和巨大差异。这项研究显示了预防 DR 的重要性，尤其是对女性和老年人。BAPC 预测表明，未来 30 年由 DR 引起的 YLD 率呈下降趋势。