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This meta-analysis aims to investigate the worldwide prevalence of primary angle-closure glaucoma (PACG) and its risk factors in the last 20 years. We conducted a systematic review and meta-analysis of 37 population-based studies and 144,354 subjects. PubMed, Embase, and Web of Science databases were searched for cross-sectional or cohort studies published in the last 20 years (2000-2020) that reported the prevalence of PACG. The prevalence of PACG was analyzed according to various risk factors. A random-effects model was used for the meta-analysis. The global pooled prevalence of PACG was 0.6% [95% confidence interval (CI) = 0.5-0.8%] for the last 20 years. The prevalence of PACG increases with age. Men are found less likely to have PACG than women (risk ratio = 0.71, 95% CI = 0.53-0.93, < 0.01). Asia is found to have the highest prevalence of PACG (0.7%, 95% CI = 0.6-1.0%). The current estimated population with PACG is 17.14 million (95% CI = 14.28-22.85) for people older than 40 years old worldwide, with 12.30 million (95% CI = 10.54-17.57) in Asia. It is estimated that by 2050, the global population with PACG will be 26.26 million, with 18.47 million in Asia. PACG affects more than 17 million people worldwide, especially leading a huge burden to Asia. The prevalence of PACG varies widely across different ages, sex, and population geographic variation. Asian, female sex, and age are risk factors of PACG.
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1.1 Epidemiology (Part of: 1 General aspects)