Rheumatoid Arthritis Associated with Dry Eye Disease and Corneal Surface Damage: A Nationwide Matched Cohort Study
Rheumatoid arthritis is potentially connected to ocular disorders, such as corneal inflammation and lacrimal gland destruction. This study aimed to evaluate the risk of dry eye disease (DED) and corneal surface damage among patients with rheumatoid arthritis. In a nationwide cohort study, we utilize...
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| Veröffentlicht in: | International journal of environmental research and public health 2023-01, Vol.20 (2), p.1584 |
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| creator | Lai, Shih-Chung Wang, Chien-Wun Wu, Yu-Ming Dai, Ying-Xiu Chen, Tzeng-Ji Wu, Hsiang-Ling Cherng, Yih-Giun Tai, Ying-Hsuan |
| description | Rheumatoid arthritis is potentially connected to ocular disorders, such as corneal inflammation and lacrimal gland destruction. This study aimed to evaluate the risk of dry eye disease (DED) and corneal surface damage among patients with rheumatoid arthritis. In a nationwide cohort study, we utilized Taiwan’s National Health Insurance research database and conducted propensity score matching to compare the risks of DED and corneal surface damage between patients with and without rheumatoid arthritis. Proportional hazards regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the outcomes of interest. The matching procedure generated 33,398 matched pairs with 501,377 person-years of follow-up for analyses. The incidence of DED was 23.14 and 10.25 per 1000 person-years in patients with and without rheumatoid arthritis, respectively. After adjusting for covariates, rheumatoid arthritis was significantly associated with DED (aHR: 2.03, 95% CI: 1.93−2.13, p < 0.0001). The association was generally consistent across the subgroups of age, sex, use of systemic corticosteroids, and different comorbidity levels. In addition, patients with rheumatoid arthritis had a higher risk of corneal surface damage (aHR: 1.36, 95% CI: 1.21−1.51, p < 0.0001) compared to control subjects. Other independent factors for corneal surface damage were age and sleeping disorders. Rheumatoid arthritis was associated with an increased risk of DED and corneal surface damage. Ophthalmological surveillance is required to prevent vision-threatening complications in this susceptible population. |
| doi_str_mv | 10.3390/ijerph20021584 |
| format | Article |
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This study aimed to evaluate the risk of dry eye disease (DED) and corneal surface damage among patients with rheumatoid arthritis. In a nationwide cohort study, we utilized Taiwan’s National Health Insurance research database and conducted propensity score matching to compare the risks of DED and corneal surface damage between patients with and without rheumatoid arthritis. Proportional hazards regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the outcomes of interest. The matching procedure generated 33,398 matched pairs with 501,377 person-years of follow-up for analyses. The incidence of DED was 23.14 and 10.25 per 1000 person-years in patients with and without rheumatoid arthritis, respectively. After adjusting for covariates, rheumatoid arthritis was significantly associated with DED (aHR: 2.03, 95% CI: 1.93−2.13, p < 0.0001). The association was generally consistent across the subgroups of age, sex, use of systemic corticosteroids, and different comorbidity levels. In addition, patients with rheumatoid arthritis had a higher risk of corneal surface damage (aHR: 1.36, 95% CI: 1.21−1.51, p < 0.0001) compared to control subjects. Other independent factors for corneal surface damage were age and sleeping disorders. Rheumatoid arthritis was associated with an increased risk of DED and corneal surface damage. Ophthalmological surveillance is required to prevent vision-threatening complications in this susceptible population.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph20021584</identifier><identifier>PMID: 36674338</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Anxiety disorders ; Arthritis ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - epidemiology ; Autoimmune diseases ; Cohort analysis ; Cohort Studies ; Comorbidity ; Complications ; Confidence intervals ; Cornea ; Corneal Injuries ; Corticoids ; Corticosteroids ; Dry Eye Syndromes - etiology ; Emergency medical care ; Eye ; Eye diseases ; Health hazards ; Health risks ; Hospitalization ; Humans ; Hypertension ; Incidence ; Lacrimal gland ; Liver diseases ; Medical personnel ; National health insurance ; Ophthalmology ; Patients ; Review boards ; Rheumatoid arthritis ; Risk ; Statistical analysis ; Steroids ; Subgroups ; Thyroid diseases ; Ulcers</subject><ispartof>International journal of environmental research and public health, 2023-01, Vol.20 (2), p.1584</ispartof><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-fdef5c298f45cf462027e7a78a4a21a1385239b49d017f9411f6cbd104a30c523</citedby><cites>FETCH-LOGICAL-c418t-fdef5c298f45cf462027e7a78a4a21a1385239b49d017f9411f6cbd104a30c523</cites><orcidid>0000-0002-5210-6873 ; 0000-0002-3279-4509 ; 0000-0002-8350-0232 ; 0000-0002-0201-4380</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861823/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861823/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36674338$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lai, Shih-Chung</creatorcontrib><creatorcontrib>Wang, Chien-Wun</creatorcontrib><creatorcontrib>Wu, Yu-Ming</creatorcontrib><creatorcontrib>Dai, Ying-Xiu</creatorcontrib><creatorcontrib>Chen, Tzeng-Ji</creatorcontrib><creatorcontrib>Wu, Hsiang-Ling</creatorcontrib><creatorcontrib>Cherng, Yih-Giun</creatorcontrib><creatorcontrib>Tai, Ying-Hsuan</creatorcontrib><title>Rheumatoid Arthritis Associated with Dry Eye Disease and Corneal Surface Damage: A Nationwide Matched Cohort Study</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>Rheumatoid arthritis is potentially connected to ocular disorders, such as corneal inflammation and lacrimal gland destruction. This study aimed to evaluate the risk of dry eye disease (DED) and corneal surface damage among patients with rheumatoid arthritis. In a nationwide cohort study, we utilized Taiwan’s National Health Insurance research database and conducted propensity score matching to compare the risks of DED and corneal surface damage between patients with and without rheumatoid arthritis. Proportional hazards regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the outcomes of interest. The matching procedure generated 33,398 matched pairs with 501,377 person-years of follow-up for analyses. The incidence of DED was 23.14 and 10.25 per 1000 person-years in patients with and without rheumatoid arthritis, respectively. After adjusting for covariates, rheumatoid arthritis was significantly associated with DED (aHR: 2.03, 95% CI: 1.93−2.13, p < 0.0001). The association was generally consistent across the subgroups of age, sex, use of systemic corticosteroids, and different comorbidity levels. In addition, patients with rheumatoid arthritis had a higher risk of corneal surface damage (aHR: 1.36, 95% CI: 1.21−1.51, p < 0.0001) compared to control subjects. Other independent factors for corneal surface damage were age and sleeping disorders. Rheumatoid arthritis was associated with an increased risk of DED and corneal surface damage. Ophthalmological surveillance is required to prevent vision-threatening complications in this susceptible population.</description><subject>Anxiety disorders</subject><subject>Arthritis</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - epidemiology</subject><subject>Autoimmune diseases</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Cornea</subject><subject>Corneal Injuries</subject><subject>Corticoids</subject><subject>Corticosteroids</subject><subject>Dry Eye Syndromes - etiology</subject><subject>Emergency medical care</subject><subject>Eye</subject><subject>Eye diseases</subject><subject>Health hazards</subject><subject>Health risks</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Incidence</subject><subject>Lacrimal gland</subject><subject>Liver diseases</subject><subject>Medical personnel</subject><subject>National health insurance</subject><subject>Ophthalmology</subject><subject>Patients</subject><subject>Review boards</subject><subject>Rheumatoid arthritis</subject><subject>Risk</subject><subject>Statistical analysis</subject><subject>Steroids</subject><subject>Subgroups</subject><subject>Thyroid diseases</subject><subject>Ulcers</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkc1v1DAQxS0EoqXlyhFZ4sJlW3_FcTggrbYFKhWQWjhbs_ak8SqJt7ZDtf89WbVULacZ6f3maZ4eIe84O5GyYadhg2nbCcYEr4x6QQ651myhNOMvn-wH5E3OG8akUbp5TQ6k1rWS0hySdNXhNECJwdNlKl0KJWS6zDm6AAU9vQulo2dpR893SM9CRshIYfR0FdOI0NPrKbXgZg0GuMFPdEl_QAlxvAse6XcorsM93MVU6HWZ_O6YvGqhz_j2YR6R31_Of62-LS5_fr1YLS8XTnFTFq3HtnKiMa2qXKu0YKLGGmoDCgQHLk0lZLNWjWe8bhvFeavd2nOmQDI3a0fk873vdloP6B2OJUFvtykMkHY2QrDPlTF09ib-sY3R3Ag5G3x8MEjxdsJc7BCyw76HEeOUraj1jGkuqxn98B-6iVMa53h7qhbCcMVn6uSecinmnLB9fIYzu6_TPq9zPnj_NMIj_q8_-RdHvpy2</recordid><startdate>20230115</startdate><enddate>20230115</enddate><creator>Lai, Shih-Chung</creator><creator>Wang, Chien-Wun</creator><creator>Wu, Yu-Ming</creator><creator>Dai, Ying-Xiu</creator><creator>Chen, Tzeng-Ji</creator><creator>Wu, Hsiang-Ling</creator><creator>Cherng, Yih-Giun</creator><creator>Tai, Ying-Hsuan</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5210-6873</orcidid><orcidid>https://orcid.org/0000-0002-3279-4509</orcidid><orcidid>https://orcid.org/0000-0002-8350-0232</orcidid><orcidid>https://orcid.org/0000-0002-0201-4380</orcidid></search><sort><creationdate>20230115</creationdate><title>Rheumatoid Arthritis Associated with Dry Eye Disease and Corneal Surface Damage: A Nationwide Matched Cohort Study</title><author>Lai, Shih-Chung ; 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This study aimed to evaluate the risk of dry eye disease (DED) and corneal surface damage among patients with rheumatoid arthritis. In a nationwide cohort study, we utilized Taiwan’s National Health Insurance research database and conducted propensity score matching to compare the risks of DED and corneal surface damage between patients with and without rheumatoid arthritis. Proportional hazards regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the outcomes of interest. The matching procedure generated 33,398 matched pairs with 501,377 person-years of follow-up for analyses. The incidence of DED was 23.14 and 10.25 per 1000 person-years in patients with and without rheumatoid arthritis, respectively. After adjusting for covariates, rheumatoid arthritis was significantly associated with DED (aHR: 2.03, 95% CI: 1.93−2.13, p < 0.0001). The association was generally consistent across the subgroups of age, sex, use of systemic corticosteroids, and different comorbidity levels. In addition, patients with rheumatoid arthritis had a higher risk of corneal surface damage (aHR: 1.36, 95% CI: 1.21−1.51, p < 0.0001) compared to control subjects. Other independent factors for corneal surface damage were age and sleeping disorders. Rheumatoid arthritis was associated with an increased risk of DED and corneal surface damage. Ophthalmological surveillance is required to prevent vision-threatening complications in this susceptible population.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36674338</pmid><doi>10.3390/ijerph20021584</doi><orcidid>https://orcid.org/0000-0002-5210-6873</orcidid><orcidid>https://orcid.org/0000-0002-3279-4509</orcidid><orcidid>https://orcid.org/0000-0002-8350-0232</orcidid><orcidid>https://orcid.org/0000-0002-0201-4380</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anxiety disorders Arthritis Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - epidemiology Autoimmune diseases Cohort analysis Cohort Studies Comorbidity Complications Confidence intervals Cornea Corneal Injuries Corticoids Corticosteroids Dry Eye Syndromes - etiology Emergency medical care Eye Eye diseases Health hazards Health risks Hospitalization Humans Hypertension Incidence Lacrimal gland Liver diseases Medical personnel National health insurance Ophthalmology Patients Review boards Rheumatoid arthritis Risk Statistical analysis Steroids Subgroups Thyroid diseases Ulcers |
| title | Rheumatoid Arthritis Associated with Dry Eye Disease and Corneal Surface Damage: A Nationwide Matched Cohort Study |
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