Department of Ophthalmology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea; and.
Cornea. 2020 Mar;39(3):348-353. doi: 10.1097/ICO.0000000000002206.
To investigate the association of systemic diseases with keratoconus in the general Korean population.
This is a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort database from 2002 to 2015, involving 1,108,369 individuals. Patients with keratoconus were identified using the Korean standard classification of diseases code H18.6. The prevalence and annual incidence rates were estimated. To examine the risk factors, 5 controls were matched per patient with keratoconus by propensity score matching using age and household income. Univariate and multivariate regression analyses were performed to assess the association between relevant factors and keratoconus.
A total of 613 subjects were identified as patients with keratoconus from the cohort database. The prevalence rate was 55.31 cases per 100,000 people [95% confidence interval (CI): 51.01-59.86]. The annual incidence rate, calculated using a predate 1-year washout period, was 4.47 cases per 100,000 person-years (95% CI: 4.11-4.85). People with allergic conjunctivitis had a 37% increased odds of being diagnosed with keratoconus [odds ratio: 1.37 (95% CI: 1.12-1.67), P = 0.002] compared with those without allergic conjunctivitis. By contrast, people with allergic rhinitis had a 52% reduced odds of being diagnosed with keratoconus [odds ratio: 0.48 (95% CI: 0.38-0.59), P < 0.001]. Atopy and eczema, asthma, connective tissue disorders, diabetes mellitus, sleep apnea, and inflammatory bowel disease had no significant association with a positive keratoconus diagnosis.
Allergic conjunctivitis may increase the risk of developing keratoconus in Koreans.
调查在韩国普通人群中，全身疾病与圆锥角膜的关系。
这是一项使用韩国国家健康保险服务-国家样本队列数据库（2002 年至 2015 年）进行的全国性基于人群的回顾性队列研究，共涉及 1108369 人。使用韩国疾病分类标准代码 H18.6 确定圆锥角膜患者。估计患病率和年发病率。为了研究危险因素，采用倾向评分匹配，每例圆锥角膜患者匹配 5 名对照，匹配年龄和家庭收入。采用单变量和多变量回归分析评估相关因素与圆锥角膜的关系。
从队列数据库中总共确定了 613 名圆锥角膜患者。患病率为每 100000 人 55.31 例[95%置信区间（CI）：51.01-59.86]。使用 1 年的前置洗脱期计算的年发病率为每 100000 人年 4.47 例（95%CI：4.11-4.85）。与没有过敏性结膜炎的患者相比，患有过敏性结膜炎的患者患圆锥角膜的几率增加了 37%[优势比（OR）：1.37（95%CI：1.12-1.67），P=0.002]。相比之下，患有过敏性鼻炎的患者患圆锥角膜的几率降低了 52%[OR：0.48（95%CI：0.38-0.59），P<0.001]。特应性和湿疹、哮喘、结缔组织疾病、糖尿病、睡眠呼吸暂停和炎症性肠病与圆锥角膜的阳性诊断无显著相关性。
过敏性结膜炎可能会增加韩国人患圆锥角膜的风险。
