Systemic Lupus Erythematosus and Risk of Dry Eye Disease and Corneal Surface Damage: A Population-Based Cohort Study

Ching-Han Tseng, Ying-Hsuan Tai, Chien-Tai Hong, Ying-Xiu Dai, Tzeng-Ji Chen, Yih-Giun Cherng and Shih-Chung Lai ()
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Ching-Han Tseng: Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
Ying-Hsuan Tai: Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
Chien-Tai Hong: Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
Ying-Xiu Dai: Department of Dermatology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Tzeng-Ji Chen: School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
Yih-Giun Cherng: Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
Shih-Chung Lai: Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

IJERPH, 2023, vol. 20, issue 5, 1-11

Abstract: Systemic lupus erythematosus (SLE) potentially involves multiple parts of the ocular system, including the lacrimal glands and the cornea. The present study sought to assess the risk of aqueous-deficient dry eye disease (DED) and corneal surface damage in patients with SLE. We conducted a population-based cohort study using Taiwan’s National Health Insurance research database to compare the risks of DED and corneal surface damage between subjects with and without SLE. Proportional hazard regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the study outcomes. The propensity score matching procedure generated 5083 matched pairs with 78,817 person-years of follow-up for analyses. The incidence of DED was 31.90 and 7.66 per 1000 person-years in patients with and without SLE, respectively. After adjusting for covariates, SLE was significantly associated with DED (aHR: 3.30, 95% CI: 2.88–3.78, p < 0.0001) and secondary Sjögren’s syndrome (aHR: 9.03, 95% CI: 6.86–11.88, p < 0.0001). Subgroup analyses demonstrated that the increased risk of DED was augmented among patients with age < 65 years and female sex. In addition, patients with SLE had a higher risk of corneal surface damage (aHR: 1.81, 95% CI: 1.35–2.41, p < 0.0001) compared to control subjects, including recurrent corneal erosion (aHR: 2.98, 95% CI: 1.63–5.46, p = 0.0004) and corneal scar (aHR: 2.23, 95% CI: 1.08–4.61, p = 0.0302). In this 12-year nationwide cohort study, we found that SLE was associated with increased risks of DED and corneal surface damage. Regular ophthalmology surveillance should be considered to prevent sight-threatening sequelae among patients with SLE.

Keywords: complication; corneal erosion; keratoconjunctivitis sicca; ocular manifestation; peripheral ulcerative keratitis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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