Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; National Allergy Research Centre, Gentofte, Denmark.
Eye Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
J Am Acad Dermatol. 2017 Aug;77(2):280-286.e1. doi: 10.1016/j.jaad.2017.03.003.
Ocular comorbidities are common in atopic dermatitis (AD) as the result of the disease itself or the use of medication. No large-scale epidemiologic data exist on the prevalence of ocular comorbidities in adults with AD.
We sought to examine the prevalence and risk of selected ocular comorbidities in adult patients with AD.
All Danish individuals ≥18 years of age were linked in nationwide registries. Adjusted hazard ratios (HRs) were estimated by means of Cox regression.
A total of 5766 and 4272 adults were categorized as having mild and severe AD, respectively. At least 1 prescription of anti-inflammatory ocular agents was claimed in 12.0% and 18.9% of patients with mild and severe AD, respectively. In adjusted analysis, the HR of conjunctivitis was 1.48 (95% confidence interval [CI], 1.15-1.90) for mild AD and 1.95 (95% CI, 1.51-2.51) for severe AD. The HR of keratitis was 1.66 (95% CI, 1.15-2.40) for mild AD and 3.17 (95% CI, 2.31-4.35) for severe AD. For adults with severe AD, the HR for keratoconus was 10.01 (95% CI, 5.02-19.96). AD was associated with "cataract only" in individuals <50 years of age.
A limitation of the study is that observational studies cannot establish causality.
Adults with AD had a significant and disease severity-dependent increased risk of development of conjunctivitis, keratitis, and keratoconus compared with that of the general population.
特应性皮炎（AD）本身或药物治疗会导致眼部合并症较为常见。目前尚无关于成人 AD 患者眼部合并症患病率的大规模流行病学数据。
我们旨在研究 AD 成年患者中特定眼部合并症的患病率和发病风险。
所有丹麦≥18 岁的个体均在全国性注册系统中进行了关联。通过 Cox 回归计算了调整后的风险比（HR）。
共有 5766 名和 4272 名成人分别被归类为患有轻度和重度 AD。分别有 12.0%和 18.9%的轻度和重度 AD 患者至少开具过 1 种抗炎性眼部药物。在调整后的分析中，轻度 AD 的结膜炎 HR 为 1.48（95%置信区间 [CI]，1.15-1.90），重度 AD 的结膜炎 HR 为 1.95（95% CI，1.51-2.51）。轻度 AD 的角膜炎 HR 为 1.66（95% CI，1.15-2.40），重度 AD 的角膜炎 HR 为 3.17（95% CI，2.31-4.35）。对于重度 AD 患者，圆锥角膜的 HR 为 10.01（95% CI，5.02-19.96）。50 岁以下的 AD 患者与“单纯白内障”相关。
本研究的局限性在于观察性研究不能确定因果关系。
与一般人群相比，AD 成年患者发生结膜炎、角膜炎和圆锥角膜的风险显著增加，且与疾病严重程度相关。
