PREVALENCE OF GLAUCOMA IN EUROPE AND PROJECTIONS TO 2050

 

Stuart et al have performed a “Two-stage, individual participant data meta-analysis” to provide updated glaucoma prevalence estimates and to quantify the current and future burden of disease in Europe.

The analysis is based on population-based European Eye Epidemiology Consortium studies with glaucoma prevalence data based on direct participant examination.

The analysis included 55415 adults ≥40 years of age (mean age, 65.6 years; 53.9% women) from 14 population-based studies (1991-2020).

The European Eye Epidemiology Consortium is a collaborative initiative of >50 European eye studies, including >180 000 participants, with the aim of promoting and facilitating epidemiologic research into common eye diseases.

The results of this analysis are as follows:

• Among the 55415 individuals included in the study, 2021 participants (3.65%) were found to have glaucoma with an age-standardized European prevalence of 2.99%.
• Older age and male sex were associated with higher prevalence.
• Despite regional and diagnostic differences in prevalence estimates, no temporal trend was identified. However, studies based on specialist opinion yielded the highest glaucoma prevalence estimate and those based on modified ISGEO criteria yielded the lowest.
• This is perhaps unsurprising given that ISGEO criteria rely on statistical cutoffs of vertical cup-to-disc ratio and cup-to-disc ratio asymmetry to define structural damage, potentially excluding cases of early disease or other characteristic features of glaucomatous optic neuropathy that may have been considered diagnostic in other studies.
• Primary open-angle glaucoma (POAG) accounted for 79.9% of all cases of glaucoma. Among other subtypes, primary angle-closure glaucoma (PACG) (9.1% of all cases) and secondary glaucoma (11.0% of all cases) were also found. 
• The prevalence for all types of glaucoma showed an increasing trend with age. However, a decline in PACG prevalence was observed after 80 years of age (PACG was most common between 60-74 years of age).
• More than half (56.4%) of cases were undiagnosed previously (new cases), with a higher proportion of undetected disease in younger participants, including >80% in those <55 years of age.
• Based on the analysis, in 2024 the burden of cases was estimated to be of 12.3 million individuals with glaucoma in Europe, including 6.9 million individuals with undiagnosed disease.
• Significant differences were found across geographic regions, with the lowest prevalence observed in Western Europe and the highest in Eastern Europe.
• Despite projections of an overall decline in total population (~11.8%) over the next 26 years, the number of glaucoma cases is projected to increase to 13.52 million (þ10.3%) by 2050. Thus, the burden of glaucoma patients is projected to grow by >1 million people by 2050 because of changing population age structure, with a preponderance of primary open-angle glaucoma.
• The annual rate of change is expected to slow, however, with a peak of 13.63 million cases reached by 2045, before a decline in total case numbers is seen.

The study concluded that:

The burden of glaucoma may be significantly underestimated if estimates are based solely on published summary statistics, rather than individual-level data, and this may have broader implications for other age-related conditions.

REFERENCE:

Stuart KV, de Vries VA, Schuster AK, Yu Y, van der Heide FCT, Delcourt C, Cougnard-Grégoire A, Schweitzer C, Brandl C, Zimmermann ME, Heid IM, Farinha C, Coimbra R, Luben RN, Hayat S, Khaw KT, Stingl JV, Pfeiffer N, Berendschot TTJM; Maastricht Study Consortium; Arnould L, Creuzot-Garcher C, Hogg R, Wright DM, Azuara-Blanco A, Vergroesen JE, Klaver CCW, Ramdas WD, Topouzis F, Giannoulis DA, Bikbov MM, Kazakbaeva GM, Jonas JB, Jansonius NM, Bourne RRA, Quigley HA, Foster PJ, Khawaja AP; European Eye Epidemiology Consortium. Prevalence of Glaucoma in Europe and Projections to 2050: Findings from the European Eye Epidemiology Consortium. Ophthalmology. 2025 Oct;132(10):1114-1124. doi: 10.1016/j.ophtha.2025.06.002. Epub 2025 Jun 9. PMID: 40499787.