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УДК: | 617.735 DOI: https://doi.org/10.25276/2410-1257-2024-4-6-10 |
Бикбов M.M., Якупова Э.М., Казакбаева Г.М., Панда-Йонас С. , Борн Р. , Гильманшин Т.Р., Йонас Й.
Оценка количества слепых и слабовидящих людей из-за возрастной макулярной дегенерации на Южном Урале
Уфимский научно-исследовательский институт глазных болезней БГМУ Минздрава России
Университет Англии Раскин
Университетский госпиталь Гейдельберга
Госпиталь Ротшильда
Частная клиника профессора Йонаса и доктора Панда-Йонаса
Сингапурский Национальный Офтальмологический центр
Университет Цинхуа
Нью-Йоркский глазной и ушной лазарет на горе Синай, Медицинская школа Икана на горе Синай
Relevance
Age-related macular degeneration (AMD) is one of the leading causes of visual impairment and blindness in Western countries and the most common cause of visual disability in developed countries. Every year we note an increase in the AMD prevalence among people aged 40 years and older, which indicates that the age of those who may develop the disease is becoming younger [1–7]. Also AMD’s social and economic impact is expected to increase substantially due to population growth and ageing [4].
About 9.4% of Australian adults are visually impaired, with AMD being the primary cause of visual impairment in half of them [8]. AMD is the leading cause of visual disability in 26% of cases in Latin America [9] and accounts for about 50% of registered blindness in the UK [10, 11]. Since 2015 retinal diseases have become the main cause of visual loss in Russia (25% of all cases), with AMD accountings for a significant proportion (12.5%) [12, 13]. However, to date, there is a lack of data on the prevalence of AMD-related vision impairment, which necessitates further research in this area.
Purpose
To analyze the prevalence of blindness and vision impairment due to age-related macular degeneration.
Material and methods
Between 2015–2017 the cross-sectional populationbased study Ural Eye and Medical Study (UEMS) was conducted at the Ufa Eye Research Institute to assess the prevalence of eye diseases among people aged 40 and older and living in the Southern Urals region. Inclusion criteria included informed consent to participate, and age of 40 years or older, and permanent residence in the Southern Urals as study region.
The survey was conducted in accordance with the basic principles of the Helsinki Declaration and Good Clinical Practice (GCP) guidelines. Informed consent was obtained from all individual participants (or legal guardians).
The study included questionnaires survey, general medical and ophthalmic examinations. The study protocol involved the assessment of 683 criteria, 293 of which were related to demographic characteristics and social status, living conditions and general health, and 355 parameters were related to eye examination results.
The ophthalmic examination included general such as: visual acuity measureemnt, refractometry, tonometry, biomicroscopy, as well as specific methods such as corneal topography, automated perimetry, fundus photography (VISUCAM 500, Carl Zeiss Meditec AG, Jena, Germany), optical coherence tomography (OCT) (RS-3000, NIDEK co., Ltd., Aichi Japan).
AMD was diagnosed based on ophthalmoscopy and OCT images. Visual acuity was determined with maximum correction.
The assessment of the presence of blindness and visual impairment was carried out in accordance with the WHO classification (for the convenience of data analysis, respondents with moderate and severe visual impairment were combined into one group):
• mild vision impairment – visual acuity (VA) from 6/12 to 6/18 inclusive (from 0.5 to 0.3 inclusive);
• moderate to severe – VA <6/18 and ≥3/60 (<0.3 and ≥0.05);
• blindness – VA <3/60 (<0.05) [14].
• Visual acuity in the better eye or single one was taken into account.
Statistical data processing was performed using the IBM SPSS Statistics 23.0 software package (USA). At p<0.05 the comparison was considered statistically significant. CI was calculated using the Wilson method with continuity correction.
Results and discussion
A total of 5893 respondents results were enrolled in the study on prevalence of causes of visual impairment. The mean age of the participants was 59.0±10.7 years (range 40–94 years). Mild visual impairment was detected in 184 respondents (3.1%; 95% CI: 2.7–3.6), moderate to severe visual impairment (MSVI) – in 182 respondents (3.1%; 95% CI: 2.7–3.5) and blindness in 11 respondents (0.19%; 95% CI: 0.10–0.34).
Among those with moderate to severe vision impairment, AMD, specifically its late stage, was the cause of vision impairment in 14 respondents (7.7%; 95% CI: 3.8–11.6), 7 of them had developed geographic atrophy (3,8%; 95% CI: 1.0– 6.7). Among the blind participants, AMD was the main cause of vision loss in 2 respondents (18.2%; 95% CI: 3.2–52.2).
The proportion of individuals with moderate to severe visual impairment due to AMD in the study population was 0.24% (95% CI: 0.14–0.41), with 0.12% (95% CI: 0.05–0.26) having low vision due to geographic atrophy, and 0,03% being blind due to AMD (95% CI: 0.01–0.14) respectively.
According to the Vision Loss Expert Group of the Global Burden of Disease (GBD) Study, a global meta-analysis estimating the number of people with low vision and blindness due to age-related macular degeneration, in 2020 6.23 million people (95% CI: 5.04–7.58) worldwide were estimated with MSVI (2,747,000 male and 2,743,000 female).
AMD-related blindness affected1.85 million people (95% CI: 1.35–2.43) (664,000 male and 1,185,000 female) Thus, in 2020, AMD ranked second among the causes of irreversible blindness globally [2]. From 2000 to 2020, there was a projected decrease in the prevalence of blindness caused by AMD in all regions except Latin America and the Caribbean, and the prevalence of AMD-related MSVI increased in many super-regions except North Africa, the Middle East and SubSaharan Africa, with wide discrepancies between regions [2].
The overall prevalence of MSVI impairment due to AMD among individuals aged 50 or older was estimated at 0.34% (95% CI: 0.27–0.41) globally, with the highest prevalence observed in North Africa and the Middle East – 0 55% (95% CI: 0.44–0.68) and the lowest in high-income countries – 0.14% (95% CI: 0.11–0.17), whilst in Central Europe, Eastern Europe and Central Asia – it was 0.16% (95% CI: 0.13–0.19).
Meanwhile, the global prevalence of blindness due to AMD was estimated in the meta-analysis to be 0.1% (95% CI: 0.08– 0.14). The regions with the highest prevalence of blindness were North Africa and the Middle East with 0.22% (95% CI: 0.16–0.30) and the regions with the lowest prevalence were Central Europe, Eastern Europe and Central Asia with 0.04% (95% CI: 0.03–0.06), also with the lowest number of individuals with presenting blindness due to AMD per world region (0.06 million people; 0.04 to 0.08) (Table) [2, 14].
The population-based study Ural Eye and Medical Study (UEMS) results showed that the number of people with moderate to severe visual impairment was close to that in Latin America and the Caribbean, higher than in Central Europe, Eastern Europe, Central Asia and lower than in North Africa and the Middle East. The proportion of people with AMD-related blindness in the Southern Ural is close to those in Central Europe, Eastern Europe and Central Asia.
ConclusionS
The prevalence of moderate to severe visual impairment due to age-related macular degeneration was 0.24% (95% CI: 0.14–0.41), the prevalence of AMD-related blindness due to AMD was 0.03% (95% CI: 0.01–0.14) in the population of Southern Urals. The findings are comparable to data obtained in the world regions and in the world’s population as a whole.
Information about the authors
Mukharram M. Bikbov – Doctor of Medical Sciences, Professor, Director of the Ufa Eye Research Institute, eye@anrb.ru, https://orcid.org/0000-0002-0569-1264
Ellina M. Iakupova – Candidate of Medical Sciences, ophthalmologist of the 2nd microsurgical department of the Ufa Eye Research Institute, rakhimova_ ellina@mail.ru, https://orcid.org/0000-0002-9616-6261
Gyulli M. Kazakbaeva – Candidate of Medical Sciences, Head of the Department of Ophthalmological and Medical Epidemiology, Ufa Eye Research Institute, gyulli.kazakbaeva@gmail.com, https://orcid.org/0000-0002-0569-1264
Songhomitra Panda-Jonas – professor, Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France, drsjonas@jmail.com, https://orcid.org/0000-0003-0709-863X
Bourn Rupert – professor, Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, England, eyesecretary. cpm@gmail.com, https://orcid.org/0000-0002-8169-1645
Timur R. Gilmanshin – Сandidate of Medical Sciences, Head of the De-partment of Vitreoretinal and Laser Surgery of the Ufa Eye Research Institute, timdoct@bk.ru, https://orcid.org/0000-0002-3896-2630
Jost B. Jonas – professor, Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France jost.jonas@medma.uni-heidelberg. de, https://orcid.org/0000-0003-2972-5227
Информация об авторах
Бикбов Мухаррам Мухтарамович – д.м.н., профессор, директор Уфимского НИИ глазных болезней ФГБОУ ВО БГМУ Минздрава России, eye@anrb.ru, https:/orcid.org/0000-0002-0569-1264 Якупова Эллина Маратовна – к.м.н., врач-офтальмолог 2 микрохирургического отделения, Уфимский НИИ ГБ ФГБОУ ВО БГМУ Минздрава России, rakhimova_ellina@mail.ru, https://orcid.org/0000-0002-9616-6261
Казакбаева Гюлли Мухаррамовна – к.м.н., заведующая отделением офтальмологической и медицинской эпидемиологии, Уфимский НИИ ГБ ФГБОУ ВО БГМУ Минздрава России, gyulli.kazakbaeva@gmail. com, https://orcid.org/0000-0002-0569-1264
Сонгхомитра Панда-Йонас – профессор, госпиталь Фонда Ротшильда, Французский институт близорукости, Париж, Франция, drsjonas@jmail.com, https://orcid.org/0000-0003-0709-863X
Руперт Борн – профессор Института исследования зрения и глазных болезней, Университет Англия Раскин, Кембридж, Англия, eyesecretary.cpm@gmail.com, https://orcid.org/0000-0002-8169-1645
Гильманшин Тимур Риксович – к.м.н., заведующий отделением витреоретинальной и лазерной хирургии Уфимского НИИ глазных болезней ФГБОУ ВО БГМУ Минздрава России, timdoct@bk.ru https://orcid.org/0000-0002-3896-2630
Йост Йонас – профессор, госпиталь Фонда Ротшильда, Французский институт близорукости, Париж, Франция jost.jonas@medma.uniheidelberg.de, https://orcid.org/0000-0003-2972-5227
Аuthor’s сontribution:
Bikbov M.M. – concept and design of research.
Iakupova E.M. – collecting and processing material, writing text.
Kazakbaeva G.M. – writing text, editing.
Panda-Jonas S. – concept and design of research.
Bourne R. – concept and design of research, editing.
Gilmanshin T.R. – collecting and processing material.
Jonas J.B. – concept and design of research, editing.
Вклад авторов:
Бикбов М.М. – концепция и дизайн исследования.
Якупова Э.М. – сбор и обработка материала, написание текста.
Казакбаева Г.М. – написание текста, редактирование.
Панда-Йонас С. – концепция и дизайн исследования, редактирование.
Борн Р. – концепция и дизайн исследования.
Гильманшин Т.Р. – сбор и обработка материала.
Йонас Й.Б. – концепция и дизайн исследования, редактирование.
Financial transparency: The authors received no funding to conduct the research or write the article.
Финансирование: Авторы не получали финансирования при проведении исследования и написании статьи.
Conflict of interest None.
Конфликт интересов: Отсутствует.
Поступила: 25.11. 2024
Переработана: 10.12. 2024
Принята к печати: 13.12. 2024
Originally received: 25.11. 2024
Final revision: 10.12. 2024
Accepted: 13.12. 2024
Страница источника: 6
OAI-PMH ID: oai:eyepress.ru:article63625
Просмотров: 130
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