Abstract
BACKGROUND: To evaluate the global, regional, and national trends of vision impairment associated with diabetic retinopathy (DR) in the working-age population (20-65 years) from 1990 to 2021. METHODS: This was a population-based analysis using data from the Global Burden of Disease Study 2021. Vision impairment was defined as low vision (Snellen visual acuity of < 6/18 to ≥ 3/60) and blindness (Snellen visual acuity of < 3/60 or central visual field < 10°). The burden of DR-related vision impairment, that is, prevalence and years lived with disability (YLD), was analyzed by sex, age, location, and sociodemographic index (SDI). A Bayesian age-period-cohort analysis was employed to forecast the future burden up to 2035. RESULTS: From 1990 to 2021, the global prevalence rate and YLD rate of DR-related vision impairment increased significantly. In 2021, 2.85 million prevalent cases and 250 117 YLDs were reported, representing 2.8-fold and 3.0-fold increases compared to 1990, respectively. South Asia and China were identified as the most severely burdened region and country in 2021, respectively. Throughout 1990-2021, females consistently bore a greater burden than males. In terms of SDI, the burden was predominantly concentrated in middle-SDI countries. Predictive analysis suggests a continued increase in the number of patients and YLDs by 2035. CONCLUSIONS: Globally, there has been a substantial increase in the burden of DR-related vision impairment among working-age individuals, with disparities observed in terms of sex, location, and SDI. Given the projected worsening of this burden, targeted interventions are needed to address this global health challenge.