{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T10:05:08Z","timestamp":1776852308856,"version":"3.51.2"},"reference-count":35,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100008750","name":"Shanghai Hospital Development Center","doi-asserted-by":"crossref","award":["SHDC2023CRD013"],"award-info":[{"award-number":["SHDC2023CRD013"]}],"id":[{"id":"10.13039\/501100008750","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Commission","doi-asserted-by":"crossref","award":["23Y11910000"],"award-info":[{"award-number":["23Y11910000"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81730025"],"award-info":[{"award-number":["81730025"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82020108006"],"award-info":[{"award-number":["82020108006"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271126"],"award-info":[{"award-number":["82271126"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Open Research Funds of the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University","award":["303060202400375"],"award-info":[{"award-number":["303060202400375"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,9,23]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Blindness, a significant complication of neonatal disorders (ND) and their four subtypes, profoundly impacts individuals\u2019 quality of life. This study assesses the global burden of blindness caused by ND to inform health policy development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were obtained from the Global Burden of Disease Study 2021 (GBD 2021). Age-standardised prevalence and years lived with disability (YLDs) were analysed using estimated annual percentage changes (EAPCs) and joinpoint model. Health disparities were evaluated through Sociodemographic Index (SDI) via the Slope Index of Inequality (SII) and Concentration Index (CI). Decomposition analysis identified burden changes, and Bayesian age-period-cohort (BAPC) models projected trends through 2040.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, global ND-related blindness cases exceeded 4.26\u2009million, reflecting a 60.92% increase in prevalence and 61.33% rise in YLDs since 1990. Age-standardised prevalence rates (ASPR) and YLDs rates (ASYR) increased, with the EAPCs of 0.29 (95% CI 0.26 to 0.32) and 0.31 (95% CI 0.28 to 0.34), respectively, primarily driven by population growth and epidemiological change. Socioeconomic disparities persisted, with higher burdens in lower SDI regions. From 2005 to 2021, prevalence peaked in the 45\u201354 age group. Projections to 2040 indicated contrasting trends: a decline in prevalence based on 1990\u20132021 trends, but a slight increase based on 1990\u20132019 trends, prior to the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The burden of ND-related blindness remains substantial. The heavier burden in low SDI regions and the delayed onset of blindness due to the cumulative effects of ND may be underestimated. Urgent improvements in medical resource allocation and long-term eye health follow-up for ND survivors are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327558","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T17:20:45Z","timestamp":1760548845000},"page":"510-519","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent socioeconomic disparities and delayed onset in blindness due to neonatal disorders: global burden and future projections"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7255-4532","authenticated-orcid":false,"given":"Shanhong","family":"Li","sequence":"first","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiai","family":"Shen","sequence":"additional","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingsu","family":"Shi","sequence":"additional","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxi","family":"Fang","sequence":"additional","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingyun","family":"Liu","sequence":"additional","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runyi","family":"Shao","sequence":"additional","affiliation":[{"name":"School of Basic Medical Science, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4422-0278","authenticated-orcid":false,"given":"Lianqun","family":"Wu","sequence":"additional","affiliation":[{"name":"Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"},{"name":"Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"2026042202150759000_110.5.510.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ICU.0000000000001099","article-title":"The global burden of blindness","volume":"36","author":"Lee","year":"2025","journal-title":"Curr Opin Ophthalmol"},{"key":"2026042202150759000_110.5.510.2","unstructured":"World Health Organization . Blindness and vision impairment. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/blindness-and-visual-impairment [Accessed 8 Mar 2025]."},{"key":"2026042202150759000_110.5.510.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjo-2022-321801"},{"key":"2026042202150759000_110.5.510.4","first-page":"e130","article-title":"Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study","volume":"9","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2026042202150759000_110.5.510.5","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2021-053924","article-title":"Retinopathy of Prematurity: A Global Perspective and Recent Developments","volume":"150","author":"Sabri","year":"2022","journal-title":"Pediatrics"},{"key":"2026042202150759000_110.5.510.6","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","year":"2024","journal-title":"The Lancet"},{"key":"2026042202150759000_110.5.510.7","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.938228","article-title":"Association of sex with the global burden of vision impairment caused by neonatal preterm birth: An analysis from the global burden of disease study 2019","volume":"10","author":"Ye","year":"2022","journal-title":"Front Public Health"},{"key":"2026042202150759000_110.5.510.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-024-18730-4","article-title":"Prevalence trends of anemia impairment in adolescents and young adults with HIV\/AIDS","volume":"24","author":"Li","year":"2024","journal-title":"BMC Public Health"},{"key":"2026042202150759000_110.5.510.9","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ophtha.2023.02.002","article-title":"Global, Regional, and National Burdens of Blindness and Vision Loss in Children and Adolescents from 1990 to 2019","volume":"130","author":"Liu","year":"2023","journal-title":"Ophthalmology"},{"key":"2026042202150759000_110.5.510.10","unstructured":"Causes of death and nonfatal causes mapped to icd codes. GHDx; 2021. Available: https:\/\/ghdx.healthdata.org\/record\/ihme-data\/gbd-2021-cause-icd-code-mappings"},{"key":"2026042202150759000_110.5.510.11","doi-asserted-by":"crossref","first-page":"e1715","DOI":"10.1016\/S2214-109X(22)00429-6","article-title":"Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019","volume":"10","author":"Haakenstad","year":"2022","journal-title":"Lancet Glob Health"},{"key":"2026042202150759000_110.5.510.12","unstructured":"Global burden of disease study 2021 (gbd 2021) socio-demographic index (sdi) 1950\u20132021. GHDx. Available: https:\/\/ghdx.healthdata.org\/record\/global-burden-disease-study-2021-gbd-2021-socio-demographic-index-sdi-1950%E2%80%932021 [Accessed 8 Mar 2025]."},{"key":"2026042202150759000_110.5.510.13","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3733"},{"key":"2026042202150759000_110.5.510.14","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2024.102873","article-title":"The global, regional, and national patterns of change in the burden of congenital birth defects, 1990-2021: an analysis of the global burden of disease study 2021 and forecast to 2040","volume":"77","author":"Bai","year":"2024","journal-title":"EClinicalMedicine"},{"key":"2026042202150759000_110.5.510.15","unstructured":"World Health Organization . Handbook on health inequality monitoring with a special focus on low- and middle-income countries. Available: https:\/\/iris.who.int\/handle\/10665\/85345 [Accessed 8 Mar 2025]."},{"key":"2026042202150759000_110.5.510.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-17573-9","article-title":"Persistence of severe global inequalities in the burden of Hypertension Heart Disease from 1990 to 2019: findings from the global burden of disease study 2019","volume":"24","author":"Lu","year":"2024","journal-title":"BMC Public Health"},{"key":"2026042202150759000_110.5.510.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-020-01133-5","article-title":"An R package for an integrated evaluation of statistical approaches to cancer incidence projection","volume":"20","author":"Knoll","year":"2020","journal-title":"BMC Med Res Methodol"},{"key":"2026042202150759000_110.5.510.18","doi-asserted-by":"crossref","first-page":"103014","DOI":"10.1016\/j.eclinm.2024.103014","article-title":"Dynamic changes and future trend predictions of the global burden of anxiety disorders: analysis of 204 countries and regions from 1990 to 2021 and the impact of the COVID-19 pandemic","volume":"79","author":"Chen","year":"2025","journal-title":"eClinicalMedicine"},{"key":"2026042202150759000_110.5.510.19","unstructured":"Office for National Statistics (ONS) . Coronavirus (covid-19) related deaths by hearing and vision impairment status. 2022. Available: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/disability\/methodologies\/coronaviruscovid19relateddeathsbyhearingandvisionimpairmentstatusenglandmethodology [Accessed 8 Mar 2025]."},{"key":"2026042202150759000_110.5.510.20","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2024.1454433","article-title":"Survival outcomes among periviable infants: a systematic review and meta-analysis comparing different income countries and time periods","volume":"12","author":"Li","year":"2024","journal-title":"Front Public Health"},{"key":"2026042202150759000_110.5.510.21","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1038\/s41433-019-0390-6","article-title":"Ophthalmic outcomes following neonatal hypoxic ischaemic encephalopathy; oculomotor, biometric and refractive data in early childhood","volume":"33","author":"James","year":"2019","journal-title":"Eye (Lond)"},{"key":"2026042202150759000_110.5.510.22","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.15-16407"},{"key":"2026042202150759000_110.5.510.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-024-04977-8","article-title":"Impact of neonatal sepsis on neurocognitive outcomes: a systematic review and meta-analysis","volume":"24","author":"Ong","year":"2024","journal-title":"BMC Pediatr"},{"key":"2026042202150759000_110.5.510.24","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.23933","article-title":"Neonatal Sepsis Episodes and Retinopathy of Prematurity in Very Preterm Infants","volume":"7","author":"Glaser","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026042202150759000_110.5.510.25","doi-asserted-by":"crossref","DOI":"10.1038\/s41746-023-00941-5","article-title":"The past, current, and future of neonatal intensive care units with artificial intelligence: a systematic review","volume":"6","author":"Keles","year":"2023","journal-title":"NPJ Digit Med"},{"key":"2026042202150759000_110.5.510.26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjpo-2023-002267","article-title":"Global, regional and national burden of retinopathy of prematurity among childhood and adolescent: a spatiotemporal analysis based on the Global Burden of Disease Study 2019","volume":"8","author":"Wang","year":"2024","journal-title":"BMJ Paediatr Open"},{"key":"2026042202150759000_110.5.510.27","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/aos.16625","article-title":"Blindness is decreasing among children born preterm during the last four decades in Denmark","volume":"102","author":"Al-Abaiji","year":"2024","journal-title":"Acta Ophthalmol"},{"key":"2026042202150759000_110.5.510.28","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1001\/jamaophthalmol.2024.0045","article-title":"Multinational External Validation of Autonomous Retinopathy of Prematurity Screening","volume":"142","author":"Coyner","year":"2024","journal-title":"JAMA Ophthalmol"},{"key":"2026042202150759000_110.5.510.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2012.02544.x"},{"key":"2026042202150759000_110.5.510.30","article-title":"Persistent barriers to achieving quality neonatal care in low-resource settings: perspectives from a unique panel of frontline neonatal health experts","volume":"7","author":"Kaur","year":"2023","journal-title":"J Glob Health Rep"},{"key":"2026042202150759000_110.5.510.31","doi-asserted-by":"crossref","unstructured":"Lassi ZS , Kedzior SG , Bhutta ZA . Community-based maternal and newborn educational care packages for improving neonatal health and survival in low- and middle-income countries. Cochrane Database Syst Rev 2019. doi:10.1002\/14651858.CD007647.pub2","DOI":"10.1002\/14651858.CD007647.pub2"},{"key":"2026042202150759000_110.5.510.32","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.earlhumdev.2012.02.001","article-title":"Visual performance in preterm infants with brain injuries compared with low-risk preterm infants","volume":"88","author":"Leonhardt","year":"2012","journal-title":"Early Hum Dev"},{"key":"2026042202150759000_110.5.510.33","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1111\/soc4.12062","article-title":"Medical Innovations: Their Diffusion, Adoption, and Critical Interrogation","volume":"7","author":"Blume","year":"2013","journal-title":"Sociol Compass"},{"key":"2026042202150759000_110.5.510.34","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-052620-093850"},{"key":"2026042202150759000_110.5.510.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2020.100900"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2025-327558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:17:09Z","timestamp":1776849429000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2025-327558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,4,22]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bjo-2025-327558"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2025-327558","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]}}}