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Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040

A Systematic Review and Meta-Analysis
  • Author Footnotes
    ∗ Y-C.T. and X.L. contributed equally to the manuscript.
    Yih-Chung Tham
    Footnotes
    ∗ Y-C.T. and X.L. contributed equally to the manuscript.
    Affiliations
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore

    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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  • Author Footnotes
    ∗ Y-C.T. and X.L. contributed equally to the manuscript.
    Xiang Li
    Footnotes
    ∗ Y-C.T. and X.L. contributed equally to the manuscript.
    Affiliations
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore

    Department of Statistics and Applied Probability, National University of Singapore, Singapore
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  • Tien Y. Wong
    Affiliations
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore

    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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  • Harry A. Quigley
    Affiliations
    Glaucoma Service and Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
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  • Tin Aung
    Affiliations
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore

    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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  • Ching-Yu Cheng
    Correspondence
    Correspondence: Ching-Yu Cheng, MD, PhD, Department of Ophthalmology, National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 7, Singapore 119228.
    Affiliations
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore

    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore

    Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore

    Duke-NUS Graduate Medical School, Singapore
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  • Author Footnotes
    ∗ Y-C.T. and X.L. contributed equally to the manuscript.

      Purpose

      Glaucoma is the leading cause of global irreversible blindness. Present estimates of global glaucoma prevalence are not up-to-date and focused mainly on European ancestry populations. We systematically examined the global prevalence of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), and projected the number of affected people in 2020 and 2040.

      Design

      Systematic review and meta-analysis.

      Participants

      Data from 50 population-based studies (3770 POAG cases among 140 496 examined individuals and 786 PACG cases among 112 398 examined individuals).

      Methods

      We searched PubMed, Medline, and Web of Science for population-based studies of glaucoma prevalence published up to March 25, 2013. Hierarchical Bayesian approach was used to estimate the pooled glaucoma prevalence of the population aged 40–80 years along with 95% credible intervals (CrIs). Projections of glaucoma were estimated based on the United Nations World Population Prospects. Bayesian meta-regression models were performed to assess the association between the prevalence of POAG and the relevant factors.

      Main Outcome Measures

      Prevalence and projection numbers of glaucoma cases.

      Results

      The global prevalence of glaucoma for population aged 40–80 years is 3.54% (95% CrI, 2.09–5.82). The prevalence of POAG is highest in Africa (4.20%; 95% CrI, 2.08–7.35), and the prevalence of PACG is highest in Asia (1.09%; 95% CrI, 0.43–2.32). In 2013, the number of people (aged 40–80 years) with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040. In the Bayesian meta-regression model, men were more likely to have POAG than women (odds ratio [OR], 1.36; 95% CrI, 1.23–1.52), and after adjusting for age, gender, habitation type, response rate, and year of study, people of African ancestry were more likely to have POAG than people of European ancestry (OR, 2.80; 95% CrI, 1.83–4.06), and people living in urban areas were more likely to have POAG than those in rural areas (OR, 1.58; 95% CrI, 1.19–2.04).

      Conclusions

      The number of people with glaucoma worldwide will increase to 111.8 million in 2040, disproportionally affecting people residing in Asia and Africa. These estimates are important in guiding the designs of glaucoma screening, treatment, and related public health strategies.

      Abbreviations and Acronyms:

      CrI (credible interval), HB (Hierarchical Bayesian), OR (odds ratio), PACG (primary angle-closure glaucoma), POAG (primary open-angle glaucoma)
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