Abstract
Purpose :
Whilst diabetic eye disease (DED) has long been a leading cause of certifiable visual impairment in the working age, hereditary eye disease (HED) has also become a leading cause in some countries. We explored trends in these causes of visual impairment registration in England and Wales over 10 years.
Methods :
Individuals who meet specific criteria are eligible for a Certificate of Visual Impairment (CVI), at one of two levels, sight-impaired (SI) or severely sight-impaired (SSI). A single main cause is listed, together with additional causes where applicable. We explored CVI registrations for the 10 years between 2009 and 2019, where DED or HED were listed as main cause, in the working age (16-64 years) in particular, and also proportions of males in HED CVIs.
Results :
In 2009-10, similar numbers of CVIs had DED and HED as the main cause (1334 and 1338 respectively). In 2018-19, respective numbers were 904 and 1539. Since 2014-15, CVIs due to DED were consistently <1000 annually, whilst those due to HED were >1400. In the 16-64 age group, DED and HED were the main causes for 600 and 720 CVIs respectively in 2009-10, and for 499 and 963 CVIs in 2018-19. In this age group, slightly more SI registrations were due to DED (n=355) than HED (n=350) in 2009-10. From 2013-2014 onwards, HED SI registrations were consistently higher; in 2019-19, 278 and 407 SI registrations were due to DED and HED respectively. For SSI registrations, these were consistently higher for HED, but the numbers diverged over the period: 279 SSI registrations were due to DED in 2009-10, and 347 in 2018-19; for HED, the numbers were 387 and 602. Over the period, males accounted for 53% of working age HED CVI registrations (95% CI, 0.52-0.54), for 55% of HED SSI registrations (0.53-0.56) and 51% of HED SI registrations (0.49-0.52).
Conclusions :
In England and Wales, annual CVI registrations due to DED have fallen whilst those due to HED have risen. HED was consistently the leading cause of SSI registration in the working age, and overtook DED as leading cause of SI registration from 2013-14 onwards. Males accounted for just over 50% of HED CVI and HED SSI registrations (confidence intervals did not cross 50%). This might relate in part to males more severely affected by X-linked disease. Our findings highlight the increasing burden of visual impairment due to HED and the need for developing therapies.
This is a 2021 ARVO Annual Meeting abstract.