Increased risk of keratopathy after psoriasis: A nationwide population-based study

Abstract

BackgroundTo evaluate whether the presence of psoriasis increases the risk of keratopathy incidence by using Taiwan’s National Health Insurance Research Database (NHIRD).Methodology/Principal findingsThis retrospective cohort study used data from the NHIRD for the 2009 to 2012 period. A total of 3,648 patients diagnosed with psoriasis were enrolled in the study group while another 14,592 individuals were selected as the control group. The study group was propensity score-matched with a group of controls who had not received a diagnosis of psoriasis. Multivariate Cox regression analysis was performed to estimate the adjusted hazard ratio (aHR) of keratopathy. For the events of keratopathy, 71 patients in the study group and 208 patients in the control group developed keratopathy with a attributable risk of 23.43 per 100,000 person-months (incidence rate ratio = 1.40; P = 0.01) which correlated to the elevated cumulative probability (P = 0.03). The multivariate analysis revealed that the risk of keratopathy was higher in patients who had psoriasis (aHR = 1.31, P = 0.04). In addition, age older than 60 years (aHR = 2.10, P<0.01) and dry eye disease (aHR = 2.79, P<0.01) would also increase the risk of developing keratopathy.ConclusionsPsoriasis was associated with an increased risk of keratopathy in patients without preexisting prominent corneal disease. Moreover, the risk of incident keratopathy increases with exposure to psoriasis.

A Multimodal Eye Assessment in Psoriatic Arthritis Patients sine-Psoriasis: Evidence for a Potential Association with Systemic Inflammation

“…Moreover, a significant correlation resulted between inflammatory markers, OSDI, and the Schirmer test. These findings are consistent with the idea of multiorgan inflammatory involvement in PsA disease sine-PsO [8,31] as demonstrated in other chronic inflammatory disorders, such as PsO [8][9][10][11][12][13], diabetes mellitus [32,33], and thyreopathies [34]. In this context, the presence of dry eye might reflect the inflammatory status being an indicator of the systemic involvement in PsA [35].…”

“…The presence of PsO may influence the occurrence of dry eye syndrome in PsA patients. As widely documented from both case-series studies and population-based studies, the presence of PsO is related to dry eye disease and its possible complications (as keratopathy) [10,11]. Dry-eye disease, in systemic inflammatory diseases, is associated with elevated levels of pro-inflammatory cytokines in tear film [12,13] Data concerning dry eye syndrome in PsA patients without PsO is lacking to date.…”

Effect of Uveitis on the Development of Keratopathy: A Population-Based Cohort Study

“…In clinical studies, systemic disorders featuring immune and inflammation impairment, such as rheumatoid arthritis and psoriasis, were associated with the occurrence of uveitis and keratopathies. 9,11,12,27 Additionally, the concomitant uveitis and keratitis in patients with rheumatoid arthritis had been reported. 28 The above evidence suggests a more universal risk of keratopathies in patients with uveitis resulting from the uveitis itself or a diffuse inflammatory reaction, which was proved by the current study.…”

The Existence of Periodontal Disease and Subsequent Ocular Diseases: A Population-Based Cohort Study

“…In addition, the application of claimed data rather than real medical documents in the current study made the evaluation of PD severity and treatment outcome impossible, and may have caused an overestimation of the clinical significance of PD since patients with transient gum swelling may also be regarded as PD in the claimed database. In addition, since putting too many variables in one regression model would lead to the problem of over-fitting [ 44 ], we could not enroll all the factors that related to PD and ocular diseases including psoriasis in our multivariable analysis [ 45 , 46 ]. Moreover, the etiology of uveitis cannot be assessed since the ICD-9/ICD-10 system did not separate infectious and noninfectious uveitis.…”