Publikation
Effective refractive error coverage in adults: a systematic review and meta-analysis of updated estimates from population-based surveys in 76 countries modelling the path towards the 2030 global target
Rupert Richard Alexander Bourne; Maria Vittoria Cicinelli; David Antony Selby; Tabassom Sedighi; Ian H Tapply; Ian McCormick; Jost B Jonas; Mohammad H Abdianwall; Mukharram M Bikbov; Tasanee Braithwaite; Matthew J Burton; Vera Carneiro; Robert J Casson; Ching-Yu Cheng; Nathan G Congdon; Catherine Creuzot-Garcher; Leon B Ellwein; Mohammad Hassan Emamian; Akbar Fotouhi; Timothy R Fricke; David S Friedman; João M Furtado; Ronnie George; Noopur Gupta; Xiaotong Han; Hassan Hashemi; Mingguang He; Abba Hydara; Aiko Iwase; Gyulli Kazakbaeva; Rajiv B Khandekar; Rohit C Khanna; Fatima Kyari; Luisa C Luque; Srinivas Marmamula; Andreas Müller; Vinay Nangia; Kovin S Naidoo; Jacqueline Ramke; Paisan Ruamviboonsuk; Solange R Salomão; Hugh R Taylor; Yih C Tham; Fotis Topouzis; Rohit Varma; Lingam Vijaya; Ningli Wang; Ya Xing Wang; Tien Y Wong; Hua Yan; Seth R Flaxman; Stuart Keel; Serge Resnikoff; Wondu Alemayehu; Aries Arditi; Alessandro Arrigo; Mukharram M Bikbov; Rupert R A Bourne; Tasanee Braithwaite; Alain M Bron; Matthew Burton; Robert J Casson; Ching-Yu Cheng; Maria Vittoria Cicinelli; Nathan G Congdon; Reza Dana; Monte A Del Monte; jenny P deva; Mo Dirani; Laura Dreer; Joshua R Ehrlich; Leon B Ellwein; Arthur G Fernandes; Seth Flaxman; Tim R Fricke; David S Friedman; João M Furtado; Gus Gazzard; Ronnie George; Billy R Hammond; Mary Elizabeth Hartnett; April D Ingram; Jost B Jonas; Songhomitra Panda-Jonas; Rim Kahloun; John H Kempen; Moncef Khairallah; Rohit C Khanna; Judy E Kim; Van C Lansingh; Janet L Leasher; Nicolas Leveziel; Jennifer Lim; Hans LIMBURG; Julie-Anne Little; Ian McCormick; Alan R Morse; David C Musch; Kovin S Naidoo; Vinay Nangia; Michal Nowak; Maurizio Battaglia Parodi; Konrad Pesudovs; Tunde Peto; Jacqueline Ramke; Pradeep Y Ramulu; Serge Resnikoff; Alan L Robin; Luca Rossetti; Tabassom Sedighi; Janet B Serle; Tueng T Shen; Rita S. Sitorus; Dwight Stambolian; Nina Tahhan; Ian Tapply; Hugh R Taylor; Yih Chung Tham; Fotis Topouzis; Miltiadis K Tsilimbaris; Rohit Varma; Gianni Virgili; Ya Xing Wang; Ningli Wang; Sheila K West; Tien Y Wong; Roger Acevedo-Castellón; Heba AlSawahli; Hery Harimanitra Andriamanjato; Ahmad Ashraf Amalius; Rosario Barrenechea; Fernando Barria von Bisschoffshausen; Ileana Brea; Anthea M Burnett; Seiha Do; Joseph Enyegue oye; Robert P Finger; Marcelo Gallarreta; Aida Giloyan; Olivia OG Gomez; Pedro A Gomez-Bastar; Reeta Gurung; Esmael Habtamu; Levi Kandeke; Jefitha Karimurio; Moses K Kasadhakawo; Joseph L Kerkula; Susan SA Kikira; Sucheta Kulkarni; Van C Lansingh; Nor T Lepcha; Wanjiku C Mathenge; Jean-Aimé Mfungwa Kibala; Nahed Mikki; Sailesh Kumar Mishra; Furahini G Mndeme; Seyed Farzad Mohammadi; Manfred Mörchen; Nasiru Muhammad; János Németh; Joshua FA Owoeye; Yawo S Prempe; Muhammad Mansur Rabiu; Alice V Ramyil; Lutfah Rif'ati; Shalinder Sabherwal; Yuddha D Sapkota; Nicholas J Sargent; Tony O Ukety; Davaatseren Uranchimeg; Anselmo Jacinto Vilanculos; Joseph W Wachira; Min Wu; Biaxiang Xiao; Mariano Yee Melgar; Xiu Juan Zhang
In: The Lancet Global Health, Vol. 1, Pages 1-10, Elsevier Ltd, 2025.
Zusammenfassung
Background In 2024, WHO included effective refractive error coverage (eREC) into the results framework of the 14th General Programme of Work, which sets a road map for global health and guides WHO's work between 2025 and 2028. eREC is a measure of both the availability and quality of refractive correction in a population. This study aimed to model global and regional estimates of eREC as of 2023 and evaluate progress towards the WHO global target of a 40 percentage-point absolute increase in eREC by 2030. Methods For this systematic review and meta-analysis, the Vision Loss Expert Group analysed data from 237 population-based eye surveys conducted in 76 countries since 2000, comprising 815 273 participants, to calculate eREC (met need / met need + undermet need + unmet need]) and the relative quality gap between eREC and REC ([REC – eREC] / REC × 100, where REC = [met + undermet need] / [met need + undermet need + unmet need]). An expert elicitation process was used to choose covariates for a Bayesian logistic regression model used to estimate eREC by country–age–sex grouping among adults aged 50 years and older. Country–age–sex group estimates were aggregated to provide estimates according to Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions. Findings Global eREC was estimated to be 65·8% (95% uncertainty interval [UI] 64·7–66·8) in 2023, 6 percentage points higher than in 2010 (eREC 59·8% [59·4–60·2]). There were marked differences in eREC between GBD super-regions in 2023, ranging from 84·0% (95% UI 83·0–85·0) in high-income countries to 28·3% (26·4–30·4) in sub-Saharan Africa. In all super-regions, eREC was lower in females than males, and decreased with increasing age among adults aged ≥50 years. Since 2000, the relative increase in eREC was 60·2% in sub-Saharan Africa, 45·7% in North Africa and the Middle East, 41·5% in southeast Asia, east Asia and Oceania, 40·3% in south Asia, 16·2% in Latin America and the Caribbean, 8·3% in central Europe, eastern Europe and central Asia, and 6·8% in the high-income super-region. The relative quality gap ranged from 2·9% to 78·3% across studies, with larger gaps characteristically in regions of lower eREC. Globally, the percentage of those with a refractive need that was undermet reduced between 2000 and 2023, from 10·0% (95% UI 9·5–10·5) to 5·3% (5·1–5·5). Interpretation The current trajectory of improvement in eREC and the relative quality gap are insufficient to meet the 2030 target. Global efforts to equitably increase spectacle coverage, such as the WHO SPECS 2030 initiative, and to address equity failings associated with geography, age, and sex, are crucial to accelerating progress towards the 2030 targets. No region is close to achieving universal coverage. Funding WHO, Sightsavers, The Fred Hollows Foundation, Fondation Thea, University of Heidelberg, German Federal Ministry for Education and Research. Translations For the French, Chinese and Spanish translations of the abstract see Supplementary Materials section.