The Prevalence Trend of Glaucoma by Age and Sex Difference in South Asia: A Systematic Review and Meta-Analysis of Population-Based Studies.

Glaucoma, a group of eye diseases, is a leading cause of irreversible blindness worldwide. However, reports on the prevalence of glaucoma in the South Asian region have not been up-to-date. This systematic review and meta-analysis aimed to estimate the pooled prevalence of glaucoma in South Asia and analyze its trends by age and sex. Adhering to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, a comprehensive search was undertaken on several electronic databases, including PubMed, Embase, Google Scholar, and Web of Science, to retrieve relevant studies published until June 2023. A total of 17 population-based studies, including 77,790 subjects (37,950 male and 39,709 female), were included in the meta-analysis based on set inclusion criteria. The pooled prevalence of glaucoma in South Asia was 2.1% (95% confidence interval [CI] 1.7-2.6). Among the subtypes, the prevalence of primary open-angle glaucoma (POAG) was 1.6% (95% CI: 1.2-2.1), primary angle-closure glaucoma (PACG) was 0.7% (95% CI: 0.4-1.0), and secondary glaucoma was 0.3% (95% CI: 0.1-0.5). The prevalence trend of glaucoma increased with age and was higher in males. POAG prevalence was found to be higher in all age groups than the prevalence of PACG and highest in people > 80 years old (7.25% vs. 2.12%). The prevalence of POAG was also higher in males (2.26%) than in females (1.61%), whereas PACG prevalence was similar for both males and females. This study highlights a significant burden of glaucoma in South Asia, particularly among older adults and males, with POAG being the most common subtype. These findings may assist public health leaders in understanding the scenario of glaucoma in South Asia and implementing public health strategies to combat glaucoma.