Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan.
Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
BMC Ophthalmol. 2023 Oct 13;23(1):415. doi: 10.1186/s12886-023-03165-z.
Inflammatory bowel disease (IBD) is associated with lacrimal gland dysfunction and ocular inflammation. The objective of this research was to elucidate the temporal relationships between IBD, dry eye disease (DED), and corneal surface damage.
In a matched nationwide cohort study, we evaluated the risk of DED and corneal surface damage associated with IBD. Multivariable Cox proportional hazards regression analyses were implemented to estimate the risk of ocular complications.
A total of 54,293 matched pairs were included for analyses. The median follow-up time was 8.3 years (interquartile range: 5.5 - 10.5). The period incidence of DED was 8.18 and 5.42 per 1000 person-years in the IBD and non-IBD groups, respectively. After adjusting for confounders, statistically significant associations were found between IBD and DED [adjusted hazard ratio (aHR): 1.43, 95% confidence interval (CI): 1.35 - 1.51, p < 0.0001], Sjögren's syndrome-related (aHR: 1.67, 95% CI:1.46 - 1.90, p < 0.0001) and non-Sjögren's syndrome-related subtypes (aHR: 1.38, 95% CI: 1.30 - 1.46, p < 0.0001). Furthermore, increased risks of corneal surface damage (aHR: 1.13, 95% CI: 1.03 - 1.24, p = 0.0094) among the patients with IBD were observed when compared with the controls. Other independent factors associated with corneal surface damage were age (aHR: 1.003), sex (male vs. female, aHR: 0.85), and monthly insurance premium (501-800 vs. 0-500 U.S. dollars, aHR: 1.45; ≥ 801 vs. 0-500 U.S. dollars, aHR: 1.32).
Our results suggested that IBD was an independent risk factor for DED and ocular surface damage. Clinical strategies are needed to prevent visual impairment or losses in these susceptible patients.
炎症性肠病（IBD）与泪腺功能障碍和眼部炎症有关。本研究旨在阐明 IBD、干眼症（DED）和角膜表面损伤之间的时间关系。
在一项匹配的全国队列研究中，我们评估了 IBD 相关的 DED 和角膜表面损伤的风险。采用多变量 Cox 比例风险回归分析估计眼部并发症的风险。
共纳入 54293 对匹配对进行分析。中位随访时间为 8.3 年（四分位距：5.5-10.5）。IBD 组和非 IBD 组的 DED 期间发生率分别为 8.18 和 5.42/1000 人年。调整混杂因素后，IBD 与 DED 之间存在统计学显著关联[校正后的危险比（aHR）：1.43，95%置信区间（CI）：1.35-1.51，p<0.0001]、干燥综合征相关（aHR：1.67，95%CI：1.46-1.90，p<0.0001）和非干燥综合征相关亚型（aHR：1.38，95%CI：1.30-1.46，p<0.0001）。此外，与对照组相比，IBD 患者角膜表面损伤的风险增加（aHR：1.13，95%CI：1.03-1.24，p=0.0094）。与角膜表面损伤相关的其他独立因素包括年龄（aHR：1.003）、性别（男性与女性，aHR：0.85）和每月保险费（501-800 美元与 0-500 美元，aHR：1.45；≥801 美元与 0-500 美元，aHR：1.32）。
我们的研究结果表明，IBD 是 DED 和眼表损伤的独立危险因素。需要临床策略来预防这些易感患者的视力损害或丧失。
