The Burden of Vision Loss Due to Diabetic Retinopathy in Asia from 1990-2021 Findings from the Global Burden of Disease Study 2021

Abstract

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. 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. From 1990 to 2021, the age-standardized prevalence rate (ASR) and YLDs rate of DR in Asia significantly increased, with higher rates consistently observed in women (p>0.05). The elderly experienced a greater burden, with increasing rates of VI and YLDs with age. Moderate vision impairment (MVI) constituted the majority of DR-related ASR in Asia. There were notable differences in the burden of DR among Asian countries. In 2021, Mauritius, Seychelles, Malaysia, and Brunei had the highest ASR, while Bangladesh, Bhutan, Mongolia, and Japan had the lowest. Cambodia exhibited the fastest growth, whereas Singapore and Pakistan showed a decline. Most Asian countries have a Sociodemographic Index (SDI) at low-medium to medium levels, and correspondingly low ASR. According to BAPC projections, by 2050, the YLDs rate for DR in Asia will decrease to 3.92 for males and 4.96 for females. Over the past 30 years, the burden of DR in Asia has increased, with persistent gender disparities and substantial variation among countries. This study displayed the importance of DR prevention, particularly for women and the elderly. BAPC projections suggested a decreasing trend in YLDs rate due to DR over the next 30 years.