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与孔源性视网膜脱离和儿童特应性皮炎的相关性:一项为期 12 年的全国队列研究。

The Association with rhegmatogenous retinal detachment and paediatric atopic dermatitis: a 12-year Nationwide Cohort Study.

机构信息

Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

出版信息

Eye (Lond). 2020 Oct;34(10):1909-1915. doi: 10.1038/s41433-020-0816-1. Epub 2020 Feb 20.

Abstract

PURPOSE

Historically, atopic dermatitis (AD) is associated with an increased risk of rhegmatogenous retinal detachment (RRD). However, uncertainty remained regarding the effect of AD itself and comorbidities (e.g., allergic diseases, cataract surgery) on RRD occurrence in a large, population-based paediatric population.

PATIENTS AND METHODS

We analysed the 12-year National Health Insurance Service database (2002-2013) covering the entire Korean population to estimate the association between AD and RRD in people aged under 20 years.

RESULTS

We identified 3142 RRD patients, and matched 18,852 controls (six controls to each RRD patient); therefore, we included 21,994 peoples under aged 20 years in the analyses. AD was more prevalent in the RRD group (329 patients, 10.47%) than the control group (1043 patients, 5.53%; P < 0.001), and so were severe AD (153 patients [4.87%] and 223 patients [1.18%], respectively; P < 0.001). In conditional logistic regression analysis, AD was associated with RRD (OR, 1.61; 95% CI, 1.93-1.87) even after adjusting for allergic conditions, connective tissue disease, uveitis, and cataract surgery. In addition, severity of AD was associated with an increased risk of RRD (OR for non-severe AD and severe AD, 1.26 [95% CI, 1.05-1.51] and 2.88 [95% CI, 2.25-3.68]).

CONCLUSION

This study suggests that AD itself is a risk factor of RRD in children by showing the association between AD and RRD occurrence and the biologic gradient even after adjustment for known confounders including allergic conditions, uveitis, and cataract surgery.

摘要

目的

从历史上看,特应性皮炎(AD)与孔源性视网膜脱离(RRD)的风险增加有关。然而,在一个大型的基于人群的儿科人群中,AD 本身及其合并症(例如过敏疾病、白内障手术)对 RRD 发生的影响仍存在不确定性。

患者和方法

我们分析了涵盖整个韩国人口的 12 年国家健康保险服务数据库(2002-2013 年),以估计 20 岁以下人群中 AD 与 RRD 之间的关联。

结果

我们确定了 3142 例 RRD 患者,并匹配了 18852 例对照(每例 RRD 患者匹配 6 例对照);因此,我们在分析中纳入了 21994 名 20 岁以下的人群。与对照组(1043 例,5.53%;P<0.001)相比,RRD 组中 AD 的发病率更高(329 例,10.47%),严重 AD 的发病率也更高(153 例[4.87%]和 223 例[1.18%];P<0.001)。在条件逻辑回归分析中,即使在调整了过敏状态、结缔组织疾病、葡萄膜炎和白内障手术后,AD 与 RRD 相关(OR,1.61;95%CI,1.93-1.87)。此外,AD 的严重程度与 RRD 的风险增加相关(非严重 AD 和严重 AD 的 OR,1.26[95%CI,1.05-1.51]和 2.88[95%CI,2.25-3.68])。

结论

本研究表明,AD 本身就是儿童 RRD 的一个危险因素,通过显示 AD 与 RRD 发生之间的关联以及即使在调整了已知的混杂因素(包括过敏状态、葡萄膜炎和白内障手术)后仍存在生物学梯度,表明 AD 与 RRD 发生之间存在关联。

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