Patients with systemic lupus erythematosus (SLE) may be more prone to developing numerous ocular disorders, including dry eye, cataracts, glaucoma and even episcleritis, scleritis and retinal vascular occlusion, a new study in the British Journal of Ophthalmology reports. Luckily, the investigation also found lupus patients likely visit the eye doctor more often than healthy individuals.
Researchers used Taiwan’s National Health Insurance Research Database and analyzed the newly diagnosed SLE cases between 2000 and 2012. They also compiled a comparison cohort from the same database consisting of 10 patients without SLE for each patient with lupus.
As far as trips to the eye doctor, the 521 patients with SLE in the study had a much higher prevalence (68.1% vs. 60.5%) and frequency (5.51 vs. 1.71 per 10 years) of outpatient visits compared with healthy individuals. The study also noted a high proportion and visit frequency in patients with SLE for ocular issues included chronic conjunctivitis, dry eye, allergic conjunctivitis, keratitis, refractive disorders, acute conjunctivitis, cataracts and retina disorders.
Additionally, the risk of dry eye syndrome (4.45), cataracts (3.18) and glaucoma (2.23) were much higher in patients with SLE with incidence rate ratios of 4.45, 3.18 and 2.23, respectively. The same was true for several SLE-related ophthalmic disorders, including episcleritis and scleritis (6.11) and retinal vascular occlusion (3.81).
“The significantly increased incidence of dry eye disease, cataracts, glaucoma, episcleritis and scleritis, and retinal vascular occlusion in patients with SLE deserves a high level of vigilance by clinicians,” the researchers wrote in their paper on the study.
Previous studies have found SLE can directly attack the retina, lacrimal gland, choroid, optical nerve and even the episclera and sclera of the ocular system. Patients may also have adverse ocular effects from long-term medications and infections due to impaired immunity.
Although prior investigations have addressed the ocular manifestations of SLE, the current investigation is the first comprehensive analysis of ophthalmic disorders of patients with SLE using population-based data, the researchers said.
|Hsu CS, Hsu CW, Lu MC, Koo M. Risks of ophthalmic disorders in patients with systemic lupus erythematosus – a secondary cohort analysis of population-based claims data. Br J Ophthalmol. March 11, 2020. [Epub ahead of print].|