Peng Shu-Ling, Huang Jing-Yang, Lee Chia-Yi, Weng Chia-Jui, Yang Shun-Fa
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.
Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C.
In Vivo. 2025 Sep-Oct;39(5):2908-2918. doi: 10.21873/invivo.14091.
BACKGROUND/AIM: Aortic stenosis (AS) is a fatal cardiovascular disease associated with metabolic syndrome and inflammation. Ocular surface diseases are also characterized by elevated inflammatory responses. Therefore, this study aimed to investigate the correlation between AS and the subsequent development of ocular surface diseases, including dry eye disease (DED) and superficial keratopathy.
A retrospective cohort study was performed via the usage of the TriNetX database. The patients were divided according to the presence of AS and a total of 421,253 patients were enrolled into both the AS and non-AS groups. The primary outcomes were the development of DED and superficial keratitis after AS. The Cox proportional hazard regression was applied to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of primary outcomes between groups.
There were 11,915 and 8,260 DED episodes in the AS and the non-AS groups, respectively. Also, there were 1,409 and 1,038 superficial keratopathy events in the AS and non-AS groups, respectively. After adjusting for all the confounders, the AS group showed a significant higher incidence of DED (aHR=1.375, 95%CI=1.337-1.414, <0.001) and superficial keratopathy (aHR=1.286, 95%CI=1.187-1.393, <0.001) compared to the non-AS group. The cumulative incidences of DED and superficial keratopathy were also significantly higher in the AS group than in the non-AS group (both <0.001). In subgroup analyses, the risk of ocular surface diseases was significantly higher in all AS subgroups except the Asian population.
The presence of AS associates with a higher risk of subsequent DED and superficial keratopathy development, which positively relate to the duration of AS.
背景/目的：主动脉瓣狭窄（AS）是一种与代谢综合征和炎症相关的致命性心血管疾病。眼表疾病也以炎症反应升高为特征。因此，本研究旨在探讨AS与随后发生的眼表疾病（包括干眼症（DED）和浅层角膜病变）之间的相关性。
通过使用TriNetX数据库进行一项回顾性队列研究。根据是否存在AS对患者进行分组，共有421253名患者被纳入AS组和非AS组。主要结局是AS后DED和浅层角膜炎的发生情况。应用Cox比例风险回归来计算两组之间主要结局的调整后风险比（aHR）和95%置信区间（CI）。
AS组和非AS组分别有11915例和8260例DED发作。此外，AS组和非AS组分别有1409例和1038例浅层角膜病变事件。在对所有混杂因素进行调整后，与非AS组相比，AS组DED（aHR=1.375，95%CI=1.337-1.414，<0.001）和浅层角膜病变（aHR=1.286，95%CI=1.187-1.393，<0.001）的发生率显著更高。AS组DED和浅层角膜病变的累积发生率也显著高于非AS组（均<0.001）。在亚组分析中，除亚洲人群外，所有AS亚组中眼表疾病的风险均显著更高。
AS的存在与随后发生DED和浅层角膜病变的较高风险相关，这与AS的持续时间呈正相关。
