Objective: To comprehend the status and changing trend in the burden of refractive errors in China from 1990 to 2019, and to furnish data-driven support for the formulation of rational strategies in refractive error prevention and control. Methods: Using the Global Burden of Disease Database 2019, data on refractive error prevalence and years lived with disability (YLD) in China from 1990 to 2019 were extracted and their standardized rates were calculated. The trend of refractive error prevalence, age, period, and gender was analyzed using joinpoint regression models. Results: From 1990 to 2019, the number of cases, prevalence rate, and YLD rate of refractive errors in China showed an upward trend, which was consistent with global trends. However, the magnitude of the increase in these parameters was higher than the global average. Conversely, the age-standardized prevalence rate and age-standardized YLD rate demonstrated a declining trend, which was also consistent with global trends, but the reduction rate was less pronounced compared to global levels. Notably, all indicators for females, including prevalence and YLD, exceeded those of males. The prevalence and YLD rates of refractive errors in China increased with age. The older individuals had higher rates compared to younger individuals. In 1990, the highest prevalence and YLD rates were found in the ≥70 years group, while the lowest rates were in the <5 years group. The age group with the most substantial increase in the burden of refractive errors was the 15 to 49 years population, which remained consistent during the three decades. The joinpoint regression analysis results revealed a stage-wise fluctuation in the age-standardized prevalence and YLD rates of refractive errors in China from 1990 to 2019. Specifically, the age-standardized prevalence rate increased by 0.765% from 1990 to 2001, decreased by 0.963% from 2001 to 2014, increased by 4.214% from 2014 to 2017, and decreased by 3.029% from 2017 to 2019. In contrast, the age-standardized YLD rate decreased by 0.113% from 1990 to 1995, increased by 2.252% from 1995 to 2000, decreased by 1.102% from 2000 to 2014, increased by 4.326% from 2014 to 2017, and decreased by 5.090% from 2017 to 2019. Conclusions: The standardized prevalence of refractive errors and the standardized YLD rate in China showed a downward trend, which was less than the global average level, but the disease burden was still heavy. Gender and age emerged as significant influencing factors for the prevalence of refractive errors and YLD. It is imperative to enhance efforts in the prevention and treatment of refractive errors among the middle-aged and elderly population. Attention should also be directed towards the increasing burden in the<50 years population.
目的： 探讨中国1990至2019年屈光不正的疾病负担现状及其发展趋势，为制定合理的屈光不正防控策略提供数据支持。 方法： 利用2019年全球疾病负担数据库，提取中国1990至2019年屈光不正患病、伤残损失生命年（YLD）等数据并计算其标化率，统计屈光不正流行趋势及年龄、时期、性别趋势，利用Joinpoint回归模型分析其变化趋势。 结果： 1990至2019年中国屈光不正患病例数、患病率、YLD率均上升，与全球变化趋势一致，但增幅均高于全球水平；标化患病率、标化YLD率均下降，与全球变化趋势一致，但降幅均低于全球水平；女性患病及YLD各指标值均大于男性。中国屈光不正患病率和YLD率随年龄的增加呈现上升的趋势，屈光不正的高年龄组患病率、YLD率总体高于低年龄组，1990年总体、男性和女性患病率、YLD率最高的年龄段均为≥70岁组，最低的均是<5岁的人群，屈光不正的疾病负担增幅最大的年龄段为15~49岁人群，2019年与1990年一致。Joinpoint回归分析结果显示，1990至2019年中国屈光不正标化患病率与标化YLD率变化趋势呈阶段性波动变化。其中，标化患病率1990至2001年、2001至2014年、2014至2017年和2017至2019年总体分别上升0.765%、下降0.963%、上升4.214%和下降3.029%；标化YLD率1990至1995年、1995至2000年、2000至2014年、2014至2017年和2017至2019年总体分别下降0.113%、上升2.252%、下降1.102%、上升4.326%和下降5.090%。 结论： 我国屈光不正的标化患病率和标化YLD率呈下降趋势，降幅均小于全球平均水平，但疾病负担仍较重。中国屈光不正患病率、YLD率的性别间差异明显，女性大于男性；此外，年龄尤其是人口老龄化或是屈光不正患病率、YLD的重要影响因素。应加强对中老年人群的屈光不正防治力度，50岁以下人群逐年上升的屈光不正的疾病负担需得到重视。.