title: Glaucoma in Asia: regional prevalence variations and future projections.
abstract: OBJECTIVE
  To evaluate glaucoma prevalence and disease burden across Asian subregions from 2013 to 2040.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of 23 population-based studies of 1318 primary open angle glaucoma (POAG) cases in 66,800 individuals and 691 primary angle closure glaucoma (PACG) cases in 72,767 individuals in Asia. Regions in Asia were defined based on United Nations' (UN) classification of macro-geographic regions. PubMed, Medline and Web of Science databases were searched for population-based glaucoma prevalence studies using standardised criteria published to 31 December 2013. Pooled glaucoma prevalence for individuals aged 40-80 years was calculated using hierarchical Bayesian approaches. Prevalence differences by geographic subregion, subtype and habitation were examined with random effects meta-regression models. Estimates of individuals with glaucoma from 2013 to 2040 were based on the UN World Population Prospects.
  
  
  RESULTS
  In 2013, pooled overall glaucoma prevalence was 3.54% (95% credible interval (CrI) 1.83 to 6.28). POAG (2.34%, 95% CrI 0.96 to 4.55) predominated over PACG (0.73%, 95% CrI 0.18 to 1.96). With age and gender adjustment, PACG prevalence was higher in East than South East Asia (OR 5.55, 95% CrI 1.52 to 14.73), and POAG prevalence was higher in urban than rural populations (OR 2.11, 95% CrI 1.57 to 2.38). From 2013 to 2040, South Central Asia will record the steepest increase in number of glaucoma individuals from 17.06 million to 32.90 million compared with other Asian subregions. In 2040, South-Central Asia is also projected to overtake East Asia for highest overall glaucoma and POAG burden, while PACG burden remains highest in East Asia.
  
  
  CONCLUSIONS
  Across the Asian subregions, there was greater glaucoma burden in South-Central and East Asia. Sustainable public health strategies to combat glaucoma in Asia are needed.
authors.affiliation: Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore.
authors.forename: Errol Wei'en
authors.initials: EW
authors.lastname: Chan
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Yih-Chung
authors.initials: YC
authors.lastname: Tham
authors.affiliation: Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Jiemin
authors.initials: J
authors.lastname: Liao
authors.affiliation: Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.affiliation: Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D044466:Asian People / Q000208:ethnology*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000208:ethnology*; D005902:Glaucoma, Open-Angle / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence
keywords: Epidemiology; Glaucoma