Yu Hun-Ju, Chuang Meng-Ni, Chu Chiao-Lun, Wu Pei-Lin, Ho Shu-Chen, Kuo Ho-Chang
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 83301, Taiwan.
J Clin Med. 2021 Mar 30;10(7):1381. doi: 10.3390/jcm10071381.
Kawasaki disease (KD) is a systemic vasculitis that primarily affects children under the age of 5 years old. The most significant complication is coronary artery lesions, but several ocular manifestations have also been reported. Recently, one study revealed an increasing incidence of myopia among KD patients. Therefore, the aim of this study was to assess the difference in myopic incidence between Kawasaki disease (KD) patients treated with aspirin and intravenous immunoglobulin (IVIG). We carried out a nationwide retrospective cohort study by analyzing the data of KD patients (ICD-9-CM code 4461) from Taiwan's National Health Insurance Research Database (NHIRD) during the period of 1996-2013. A total of 14,102 diagnosed KD were found in Taiwan during the study period. After excluded missing data, treatment strategy and age distribution, a total of 1446 KD patients were enrolled for analysis including 53 of which received aspirin (without IVIG) and 1393 of which were treated with IVIG. Patients who had myopia, astigmatism, glaucoma, cataract, etc. prior to their KD diagnosis were excluded. The age range was 0 to 6 years old. According to the cumulative curves, our results demonstrated that the myopic incidence in the IVIG group was significantly lower than the aspirin group (hazard ratio: 0.59, 95% confidence intervals: 0.36~0.96, = 0.02). Treatment with IVIG for KD patients may have benefit for myopia control. Compared to aspirin, IVIG may decrease the myopic risk in KD patients. However, it needs further investigation including clinical vision survey of myopia due to the limitations of this population-based study.
川崎病（KD）是一种主要影响5岁以下儿童的全身性血管炎。最严重的并发症是冠状动脉病变，但也有一些眼部表现的报道。最近，一项研究显示川崎病患者近视发病率呈上升趋势。因此，本研究的目的是评估接受阿司匹林和静脉注射免疫球蛋白（IVIG）治疗的川崎病（KD）患者之间近视发病率的差异。我们通过分析台湾国民健康保险研究数据库（NHIRD）中1996 - 2013年期间川崎病患者（ICD - 9 - CM编码4461）的数据进行了一项全国性回顾性队列研究。研究期间在台湾共发现14102例确诊的川崎病患者。在排除缺失数据、治疗策略和年龄分布后，共纳入1446例川崎病患者进行分析，其中53例接受阿司匹林治疗（未接受IVIG），1393例接受IVIG治疗。排除在川崎病诊断前患有近视、散光、青光眼、白内障等疾病的患者。年龄范围为0至6岁。根据累积曲线，我们的结果表明IVIG组的近视发病率显著低于阿司匹林组（风险比：0.59，95%置信区间：0.36~0.96，P = 0.02）。对川崎病患者使用IVIG治疗可能有助于控制近视。与阿司匹林相比，IVIG可能降低川崎病患者的近视风险。然而，由于这项基于人群的研究存在局限性，需要进一步调查，包括对近视的临床视力调查。
