Patient and Economic Burden of Presbyopia: A Systematic Literature Review

Figures & data

Table 1 Inclusion and Exclusion Criteria

	Inclusion Criteria	Exclusion Criteria
Population	Patients with presbyopia (including presbyopia along with cataract [pre-operative as well as post-operative]) Presbyopia with other refractive errors (eg, astigmatism) Age - No restriction	Patient population other than presbyopia
Interventions	Not applicable	Not applicable
Comparators	Not applicable	Not applicable
Outcomes	Epidemiology Prevalence and incidence rates of presbyopia Economic burden Direct and indirect costs of presbyopia correction Healthcare resource utilization Productivity loss Patient burden Impact on vision-related quality of life Disability and impact on daily activities Utility associated with presbyopia Patient satisfaction	Studies not reporting outcomes of interest
Study designs	RCTs and observational studies SLRs	Reviews/Case-studies/Editorial/Case reports/Case series

Abbreviations: RCTs, randomized controlled trial; SLR, systematic literature review.

Figure 1 PRISMA flow chart.

Note: The numbers of studies under different section headings are not exclusive as some studies fall under more than one section.

Abbreviations: N, number of publications; PD, pharmacodynamics; PK, pharmacokinetics.

Table 2 Characteristics of the Included Studies

Study Name	Study Design	Country	Setting	Study Period	Sample Size	Age, Mean (SD) Years	Female (%)	Outcomes
Patient burden
Kandel et al 2017^Citation60	Cross-sectional study	Australia	Multicenter		48	Median: 49 (min: 22; max: 76)	59%	Impact on daily activities
Luo et al 2008^Citation65	Cross-sectional study	US	Multicenter	NR	110	59.8 (12.2)	71%	Utility associated with corrected presbyopia
Holden et al 2008^Citation15	SLR	Global	NA	2005	NA	NA	NA	Disabilities
McDonnell et al 2004^Citation58,Citation69	Cross-sectional study	US	Multicenter	June 1999 to January 2001	637	Range: 32–56	56% to 79%	QoL
Tahhan et al 2013^Citation66	Cross-sectional study	Australia	Multicenter	July 2010 to January 2012	341	52 (7)	58.10%	Utility associated with uncorrected presbyopia
Kandel et al 2017^Citation61	Cross-sectional study	Nepal	Multicenter	September to November 2016	101	34.4 (15.1)	45.5%	Impact on daily activities
Hatef et al 2016^Citation63	Secondary research using GBD 2010 study	Iran	NA	1990–2010	NA	NA	NA	Disability adjusted life years
Muhammad et al 2015^Citation57	Cross-sectional study	Nigeria	Multicenter	2012	650	53.6 (95% CI: 52.8–54.3)	39.20%	Impact on daily activities
Lu et al 2011^Citation36,Citation37	Cross-sectional study	China	Multicenter	June to July 2009	1008	57.5 (10.5)	57.50%	Impact on daily activities
Toit et al 2010^Citation59	Cross-sectional study	Timor-Leste	Multicenter	2005	704	58.3 (12.8)	49.4%	HRQoL, Impact on daily activities
Sherwin et al 2008^Citation28	Cross-sectional study	Kenya	Multicenter	NR	134	65.2 (10.3)	NR	Impact on daily activities
Patel et al 2007^Citation21,Citation62	Cross-sectional study	Tanzania	Multicenter		1709	53.4 (range: 40–91)	55.90%	Impact on daily activities
Economic burden
Frick et al 2015^Citation5	Economic evaluation	Global	NR	2011	NR	NR	NR	Global productivity loss associated with presbyopia

Abbreviations: NA, not applicable; NR, not reported; SD, standard deviation; CI, confidence interval; US, United States; UK, United Kingdom; GBD, Global Burden of Disease; HRQoL, health-related quality of life.

Figure 2 Impact of uncorrected presbyopia on daily activities. Sources: Holden et al,¹⁵ Kandel et al,⁶⁰ Kandel et al,⁶¹ Sherwin et al,²⁸ and Patel et al.⁶².

Figure 3 Variation in health-related quality of life scores (utilities) for corrected and uncorrected presbyopia patients. Sources: Luo et al⁶⁵ and Tahhan et al.⁶⁶

Figure 4 Global productivity loss associated with uncorrected presbyopia. Sources: Frick et al (2015).⁵.

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Kandel H, Khadka J, Shrestha MK, et al. Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study. Ophthalmic Epidemiol. 2018;25(2):147–161. doi:10.1080/09286586.2017.1376338

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Hatef E, Mohammadi SF, Alinia C, et al. National burden of eye diseases in Iran, 1990–2010; findings from the global burden of diseases study 2010. Middle East Afr J Ophthalmol. 2016;23(1):89–95. doi:10.4103/0974-9233.171781

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Muhammad N, Alhassan MB, Umar MM. Visual function and vision-related quality of life in presbyopic adult population of Northwestern Nigeria. Niger Med J. 2015;56(5):317–322. doi:10.4103/0300-1652.170379

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Lu Q, Congdon N, He X, Murthy GV, Yang A, He W. Quality of life and near vision impairment due to functional presbyopia among rural Chinese adults. Invest Ophthalmol Vis Sci. 2011;52(7):4118–4123. doi:10.1167/iovs.10-6353

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Lu Q, He W, Murthy GV, et al. Presbyopia and near-vision impairment in rural northern China. Invest Ophthalmol Vis Sci. 2011;52(5):2300–2305. doi:10.1167/iovs.10-6569

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Du Toit R, Palagyi A, Ramke J, Brian G, Lamoureux EL. The impact of reduced distance and near vision on the quality of life of adults in Timor-Leste. Ophthalmology. 2010;117(12):2308–2314. doi:10.1016/j.ophtha.2010.03.041

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Sherwin JC, Keeffe JE, Kuper H, Islam FM, Muller A, Mathenge W. Functional presbyopia in a rural Kenyan population: the unmet presbyopic need. Clin Exp Ophthalmol. 2008;36(3):245–251. doi:10.1111/j.1442-9071.2008.01711.x

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Patel I, West SK. Presbyopia: prevalence, impact, and interventions. Community Eye Health. 2007;20(63):40–41.

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Patel I, Munoz B, Burke AG, et al. Impact of presbyopia on quality of life in a rural African setting. Ophthalmology. 2006;113(5):728–734. doi:10.1016/j.ophtha.2006.01.028

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Frick KD, Joy SM, Wilson DA, Naidoo KS, Holden BA. The global burden of potential productivity loss from uncorrected presbyopia. Ophthalmology. 2015;122(8):1706–1710. doi:10.1016/j.ophtha.2015.04.014

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