Objective: To provide updated glaucoma prevalence estimates and to quantify the current and future burden of disease in Europe.

Design: Two-stage, individual participant data meta-analysis.

Participants: 55 415 adults aged 40 years and older (mean age 65.6 years, 53.9% women) from fourteen population-based studies (1991-2020) with case ascertainment based on direct ophthalmic examination, ten of which have not been included in previous meta-analyses.

Methods: Within each study, age- and sex-stratified glaucoma prevalence was calculated, before pooling results using random-effects meta-analysis and performing age standardization. Meta-regression and subgroup analyses were used to assess for temporal trends and to investigate heterogeneity across clinically relevant subgroups. Estimates were applied to European population projections to predict the number of individuals with glaucoma.

Main outcome measures: Age-standardized prevalence (European Standard Population, 2013) of total and previously undiagnosed glaucoma for individuals aged 40 years and older. Annual projected number of glaucoma cases (UN World Population Prospects, 2022) in Europe to 2050.

Results: Overall, 2 021 participants (3.65%) were diagnosed with glaucoma with an age-standardized European prevalence of 2.99% (95% CI, 2.86-3.12). Older age (OR 1.32 per 5-year increase; 95% CI 1.29-1.36; P<0.001) and male sex (OR 1.18; 95% CI 1.08-1.30; P<0.001) were associated with higher prevalence. Despite regional and diagnostic differences in prevalence estimates, no temporal trend was identified over the study period. More than half (56.4%) of cases were previously undiagnosed, with a higher proportion of undetected disease in younger participants, including over 80% in those aged less than 55 years. We estimate a current burden of 12.3 million individuals with glaucoma in Europe, including 6.9 million undiagnosed cases. This burden is projected to grow by more than one million cases by 2050 due to changing population age structure, with a preponderance of primary open-angle glaucoma.

Conclusions: The current and future burden of glaucoma in Europe may be substantially higher than previously estimated, with a considerable proportion of disease in the general population remaining undetected. This may have broader implications for other age-related conditions where the number of affected individuals is based solely on published aggregate-level data.

Keywords: E3 Consortium; Europe; Glaucoma; Meta-analysis; Prevalence.

Copyright © 2025. Published by Elsevier Inc.

目标：

为了提供最新的青光眼流行率估计，并量化欧洲当前和未来的疾病负担。

设计：

两阶段个体参与者数据荟萃分析。

参与者：

来自14项基于人群的研究（1991-2020）的55,415名年龄在40岁及以上的成年人（平均年龄65.6岁，女性占53.9%），这些研究中的病例鉴定是基于直接眼科检查结果，其中10项研究未被之前的荟萃分析包含。

方法：

在每个研究中计算按年龄和性别分层的青光眼流行率，在此之前使用随机效应荟萃分析汇总结果并进行年龄标准化。使用元回归和亚组分析来评估时间趋势，并调查临床相关亚群之间的异质性。将估计值应用于欧洲人口预测，以预测患有青光眼的人数。

主要结局指标：

根据2013年欧洲标准人口的年龄标准化流行率（40岁及以上人群的总青光眼和之前未诊断的青光眼）。根据联合国世界人口展望（2022），至2050年在欧洲每年预期的新发病例数。

结果：

总体而言，有2,021名参与者（3.65%）被诊断出患有青光眼，在年龄标准化后，欧洲的患病率为2.99%（95% CI 2.86-3.12）。随着年龄增长（每增加5岁比值比OR为1.32；95% CI 1.29-1.36；P结论：

与之前估计相比，欧洲当前和未来的青光眼疾病负担可能更高，在一般人群中仍有许多未被发现的疾病。这可能会对其他年龄相关性疾病产生更广泛的影响，这些疾病的患者数量仅基于已发布的汇总数据进行计算。

关键词：

E3联盟；欧洲；青光眼；荟萃分析；流行率。