Incidence, prevalence, and risk of selected ocular disease in adults with atopic dermatitis

BACKGROUND: Ocular comorbidities are common in atopic dermatitis (AD) as the result of the disease itself or the use of medication. No large-scale epidemiologic data exist on the prevalence of ocular comorbidities in adults with AD.

OBJECTIVES: We sought to examine the prevalence and risk of selected ocular comorbidities in adult patients with AD.

METHODS: All Danish individuals ≥18 years of age were linked in nationwide registries. Adjusted hazard ratios (HRs) were estimated by means of Cox regression.

RESULTS: A total of 5766 and 4272 adults were categorized as having mild and severe AD, respectively. At least 1 prescription of anti-inflammatory ocular agents was claimed in 12.0% and 18.9% of patients with mild and severe AD, respectively. In adjusted analysis, the HR of conjunctivitis was 1.48 (95% confidence interval [CI], 1.15-1.90) for mild AD and 1.95 (95% CI, 1.51-2.51) for severe AD. The HR of keratitis was 1.66 (95% CI, 1.15-2.40) for mild AD and 3.17 (95% CI, 2.31-4.35) for severe AD. For adults with severe AD, the HR for keratoconus was 10.01 (95% CI, 5.02-19.96). AD was associated with "cataract only" in individuals <50 years of age.

LIMITATIONS: A limitation of the study is that observational studies cannot establish causality.

CONCLUSIONS: Adults with AD had a significant and disease severity-dependent increased risk of development of conjunctivitis, keratitis, and keratoconus compared with that of the general population.