|Metabolic syndrome, hypertension, hyperlipidemia and—as this new study shows—diabetes are all risk factors shared by psoriasis and retinal vein occlusion. Photo: Cleveland Clinic. Click image to enlarge.|
Previous studies have shown that ophthalmic complications arise in psoriasis patients, such as blepharitis, conjunctivitis, dry eye and uveitis. In a recent study, researchers explored how psoriasis is linked to the occurrence of retinal vein occlusion (RVO) in the diabetic population.
Over 2.7 million type 2 diabetic mellitus (DM) patients were included—23,725 were classified as having psoriasis group and the rest were considered the control group. The study focused on patients ≥20 years of age. The incidence rate of RVO was compared between the two groups.
A total of 497 RVO cases occurred in the psoriasis group and 42,388 cases occurred in the control group. An elevated risk of vein occlusion was found in individuals with both psoriasis and diabetes compared to those with diabetes alone. The findings of this study suggested that the presence of psoriasis increases RVO likelihood, the authors concluded in their paper for the Retina journal.
“The precise mechanisms underlying the association between psoriasis and RVO remain unclear; however, it is hypothesized that the inflammatory state and increased vascular complications observed in psoriasis patients may contribute to the occurrence of RVO,” the authors wrote. “These shared pathogenic mechanisms provide a plausible explanation for the association.” Epidemiological studies have identified common risk factors between psoriasis and RVO, such as hypertension, diabetes mellitus, and hyperlipidemia. In addition, the study notes, metabolic syndrome is recognized as a risk factor for both psoriasis and RVO.
“Elevated platelet volume and platelet distribution width are markers of platelet activation and may hence be associated with thrombosis in RVO,” the authors continued. “This shared pathogenesis between psoriasis and RVO could explain the increased risk of occlusive vascular diseases, such as atherosclerosis, coronary artery disease and cerebrovascular disease, observed in both conditions.”
The authors suggest that physicians need to be vigilant for the occurrence of RVO in diabetes patients who also have psoriasis.
Psoriasis increases retinal vein occlusion risk in diabetic patients: a nationwide population-based study. Retina. August 21, 2023. [Epub ahead of print.]