Department of Ophthalmology.
Department of Medical Research, Chi Mei Medical Center.
J Glaucoma. 2024 Oct 1;33(10):735-741. doi: 10.1097/IJG.0000000000002464. Epub 2024 Jul 19.
Severe atopic dermatitis (AD) in patients with glaucoma heightens the risk of requiring surgical intervention, necessitating prompt specialist care and strict surveillance.
The impact of AD on the prognosis of patients with glaucoma is rarely studied. This study aims to assess the risk of requiring glaucoma surgery among patients with glaucoma with and without AD.
In this retrospective cohort analysis, we assessed patients with glaucoma initially diagnosed from December 5, 2003 to December 3, 2018 using the TriNetX database, dividing them into AD and non-AD cohorts. 1:1 propensity-score matching created balanced groups for baseline traits and comorbidities. We compared the cohorts' risk and cumulative incidence of needing glaucoma surgery (minimally invasive glaucoma surgery, trabeculectomy, aqueous shunt, or transscleral cyclophotocoagulation). A subgroup analysis was also conducted for patients with severe AD.
Out of 528,469 patients with glaucoma, 2624 were in the AD group. Among the AD group, 584 had severe AD. The AD group showed a comparable risk of requiring surgery to the non-AD group (hazard ratio: 1.03; 95% CI: 0.72, 1.47). In contrast, the severe AD group demonstrated a significantly greater risk and cumulative incidence of surgery (hazard ratio: 2.80; 95% CI: 1.37, 5.73; log-rank P = 0.003) compared with the non-AD group.
Patients with glaucoma with severe AD are significantly more likely to need surgical intervention, with AD severity being a correlating factor for increased risk.
患有青光眼的严重特应性皮炎(AD)会增加患者需要手术干预的风险,需要及时寻求专家治疗和严格监测。
AD 对青光眼患者预后的影响很少被研究。本研究旨在评估患有和不患有 AD 的青光眼患者需要接受青光眼手术的风险。
在这项回顾性队列分析中,我们使用 TriNetX 数据库评估了 2003 年 12 月 5 日至 2018 年 12 月 3 日首次诊断为青光眼的患者,将他们分为 AD 和非 AD 队列。采用 1:1 倾向评分匹配创建基线特征和合并症平衡的组。我们比较了两组需要接受青光眼手术(微创青光眼手术、小梁切除术、房水引流术或经巩膜睫状体光凝术)的风险和累积发生率。还对严重 AD 患者进行了亚组分析。
在 528469 名青光眼患者中,有 2624 名患者患有 AD。在 AD 组中,有 584 名患者患有严重 AD。AD 组与非 AD 组手术需求风险相当(风险比:1.03;95%CI:0.72,1.47)。相比之下,严重 AD 组的手术风险和累积发生率明显高于非 AD 组(风险比:2.80;95%CI:1.37,5.73;对数秩 P=0.003)。
患有严重 AD 的青光眼患者更有可能需要手术干预,AD 的严重程度是增加风险的相关因素。