The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study
Autoimmune thyroid diseases (ATDs) are potentially connected to lacrimal gland dysfunction and ocular surface disruption. This study aimed to evaluate the relationships between ATD, dry eye disease (DED), and corneal surface damage. In a matched nationwide cohort study, we used Taiwan’s National Hea...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/9/3203 |
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| author | Eric W. Lai Ying-Hsuan Tai Hsiang-Ling Wu Ying-Xiu Dai Tzeng-Ji Chen Yih-Giun Cherng Shih-Chung Lai |
| author_facet | Eric W. Lai Ying-Hsuan Tai Hsiang-Ling Wu Ying-Xiu Dai Tzeng-Ji Chen Yih-Giun Cherng Shih-Chung Lai |
| author_sort | Eric W. Lai |
| collection | DOAJ |
| description | Autoimmune thyroid diseases (ATDs) are potentially connected to lacrimal gland dysfunction and ocular surface disruption. This study aimed to evaluate the relationships between ATD, dry eye disease (DED), and corneal surface damage. In a matched nationwide cohort study, we used Taiwan’s National Health Insurance research database to compare the incidences of DED and corneal surface damage between subjects with and without ATD. Multivariable Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the ophthalmological outcomes. A total of 50,251 matched pairs with 748,961 person-years of follow-up were included for analysis. The incidence of DED was 16.37 and 8.36 per 1000 person-years in the ATD and non-ATD groups, respectively. ATDs were significantly associated with increased DED (aHR: 1.81, 95% CI: 1.73–1.89, <i>p</i> < 0.0001). This association was generally consistent across the subgroups of age, sex, different comorbidity levels, and use of systemic corticosteroids or not. Furthermore, patients with ATD had a higher risk of corneal surface damage compared with non-ATD subjects (aHR: 1.31, 95% CI: 1.19–1.44, <i>p</i> < 0.0001), including recurrent corneal erosions (aHR: 2.00, 95% CI: 1.66–2.41, <i>p</i> < 0.0001) and corneal scars (aHR: 1.26, 95% CI: 1.01–1.59, <i>p</i> = 0.0432). Other independent factors for corneal surface damage were age, sex, diabetes mellitus, Charlson Comorbidity Index scores, and use of systemic corticosteroids. Our results suggested that ATDs were associated with higher risks of DED and corneal surface damage. Considering the high prevalence of ATD, prophylactic and therapeutic strategies should be further developed to prevent irreversible vision loss in this susceptible population. |
| first_indexed | 2024-03-11T04:15:38Z |
| format | Article |
| id | doaj.art-e0bec1bdbb8e406ebc8b23b987171bd4 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:15:38Z |
| publishDate | 2023-04-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-e0bec1bdbb8e406ebc8b23b987171bd42023-11-17T23:12:04ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01129320310.3390/jcm12093203The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort StudyEric W. Lai0Ying-Hsuan Tai1Hsiang-Ling Wu2Ying-Xiu Dai3Tzeng-Ji Chen4Yih-Giun Cherng5Shih-Chung Lai6University of Maryland School of Medicine, Baltimore, MD 21201, USADepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanAutoimmune thyroid diseases (ATDs) are potentially connected to lacrimal gland dysfunction and ocular surface disruption. This study aimed to evaluate the relationships between ATD, dry eye disease (DED), and corneal surface damage. In a matched nationwide cohort study, we used Taiwan’s National Health Insurance research database to compare the incidences of DED and corneal surface damage between subjects with and without ATD. Multivariable Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the ophthalmological outcomes. A total of 50,251 matched pairs with 748,961 person-years of follow-up were included for analysis. The incidence of DED was 16.37 and 8.36 per 1000 person-years in the ATD and non-ATD groups, respectively. ATDs were significantly associated with increased DED (aHR: 1.81, 95% CI: 1.73–1.89, <i>p</i> < 0.0001). This association was generally consistent across the subgroups of age, sex, different comorbidity levels, and use of systemic corticosteroids or not. Furthermore, patients with ATD had a higher risk of corneal surface damage compared with non-ATD subjects (aHR: 1.31, 95% CI: 1.19–1.44, <i>p</i> < 0.0001), including recurrent corneal erosions (aHR: 2.00, 95% CI: 1.66–2.41, <i>p</i> < 0.0001) and corneal scars (aHR: 1.26, 95% CI: 1.01–1.59, <i>p</i> = 0.0432). Other independent factors for corneal surface damage were age, sex, diabetes mellitus, Charlson Comorbidity Index scores, and use of systemic corticosteroids. Our results suggested that ATDs were associated with higher risks of DED and corneal surface damage. Considering the high prevalence of ATD, prophylactic and therapeutic strategies should be further developed to prevent irreversible vision loss in this susceptible population.https://www.mdpi.com/2077-0383/12/9/3203corneal ulcerGraves’ ophthalmopathykeratoconjunctivitis siccaperipheral ulcerative keratitisthyroid eye disease |
| spellingShingle | Eric W. Lai Ying-Hsuan Tai Hsiang-Ling Wu Ying-Xiu Dai Tzeng-Ji Chen Yih-Giun Cherng Shih-Chung Lai The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study Journal of Clinical Medicine corneal ulcer Graves’ ophthalmopathy keratoconjunctivitis sicca peripheral ulcerative keratitis thyroid eye disease |
| title | The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study |
| title_full | The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study |
| title_fullStr | The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study |
| title_full_unstemmed | The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study |
| title_short | The Association between Autoimmune Thyroid Disease and Ocular Surface Damage: A Retrospective Population-Based Cohort Study |
| title_sort | association between autoimmune thyroid disease and ocular surface damage a retrospective population based cohort study |
| topic | corneal ulcer Graves’ ophthalmopathy keratoconjunctivitis sicca peripheral ulcerative keratitis thyroid eye disease |
| url | https://www.mdpi.com/2077-0383/12/9/3203 |
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