Systematic Review of Vitreoretinal Diseases in Bhutan

Understanding disease epidemiology is critical for planning and implementing health programs, particularly in countries like Bhutan with limited resources and data. We reviewed published data on vitreoretinal diseases in Bhutan and found 16 such publications. Of those, two were population-based Rapid Assessment of Avoidable Blindness surveys, and others included hospital-based national survey publications and five case reports. The Rapid Assessment of Avoidable Blindness survey conducted in 2009 reported that posterior segment disorders caused 22.1% of blindness, while a similar follow-up survey in 2018 reported it had reduced to 7.8%. This improvement perhaps was due to national Vitreoretinal services established in early 2012. Hypertensive retinopathy was the most common disorder (18.9%), and other disorders included diabetic retinopathy, diabetic macular edema, retinal detachment, age-related macular degeneration, macular hole, myopic retinal degeneration and vitreous hemorrhage. Even rare disorders like seasonal hyper-acute pan-uveitis, acute retinal necrosis, central retinal artery occlusion, and nephrotic maculopathy had been treated. Bhutan, with its serene environment, is no exception to the varied vitreoretinal disease spectrum. Bhutan needs to focus on changing lifestyles, while still improving human resources and management strategies.