The severity of atopic dermatitis and the age at diagnosis may increase the risk of eye disease

Moderate to severe disease, early childhood, and systemic treatments were all associated with an increased risk of conjunctivitis in patients with atopic dermatitis, while the use of soft and rigid contact lenses was associated with a higher risk of conjunctivitis. risk of keratitis.

According to the results of a study published in Journal of the European Academy of Dermatology and Venereology.

AD, a prevalent inflammatory skin disease that often begins in early childhood, has been associated with an increased risk of OMS, factors such as treatment with dupilumab and other interleukin (IL) -13 inhibitors. having been associated with an increased frequency, most often conjunctivitis.

“Hanifin and Rajka’s criteria for AD include ophthalmologic signs such as recurrent conjunctivitis, keratoconus, and anterior subcapsular cataract as minor criteria, indicating that these conditions are part of AD syndrome,” have explained the researchers.

Noting the lack of knowledge regarding the incidence, patient characteristics and risk factors of ODS in people with AD, they conducted a national cross-sectional questionnaire survey of adult patients with AD from Denmark registered in the national patient registry between 2000-2019 and 7044 (n = 7044; mean [SD] age, 39.0 [15.5] years; 67.4% women).

Participants were screened for the primary outcomes of OSD prevalence and severity, according to the Ocular Surface Disease Index (OSDI). OSDs assessed for conjunctivitis, blepharitis, keratitis, keratoconus, symblepharon, pterygium, and hordeolum included.

“The questionnaire contained branching logic questions on the characteristics, signs and symptoms of AD patients, treatment, OMS and atopic co-morbidities.” Treatment of AD has been categorized according to current or self-reported use of topical, systemic, and biologic therapy.

In the study cohort, the SCORing Patient-Oriented Atopic Dermatitis (PO-SCORAD) criteria identified mild disease in 49% of patients with AD, moderate disease in 35%, severe disease in 10 % and in 6% an inactive disease. In addition, 44.3% reported physician-diagnosed bronchial asthma and 55.8% rhinitis.

The lifetime prevalence of OSD was 66.6% for conjunctivitis, 63.5% for hordeolum, 11.0% for blepharitis, 9.7% for keratitis, 2.0% for pterygium, 1 , 5% for symblepharon and 1.1% for keratoconus, and 12.7% reported current conjunctivitis.

Several factors have been shown to be associated with the occurrence of conjunctivitis throughout life:

  • Light MA (adjusted odds ratio [aOR], 1.48; 95% CI, 1.02-2.14)
  • Moderate AD (aOR, 1.73; 95% CI, 1.19-2.53)
  • Severe AD (aOR, 2.17; 95% CI, 1.42-3.21)
  • Bronchial asthma and rhinitis (aOR, 1.76; 95% CI, 1.49-2.07)
  • Childhood onset of AD (aOR, 1.34; 95% CI, 1.16-1.56)
  • Systemic treatment of AD (aOR, 1.27; 95% CI, 1.08-1.50)

The use of soft and hard contact lenses has also been found to be associated with the development of keratitis over the lifespan (soft contact lenses: aOR, 2.15; 95% CI, 1.65- 2.80; rigid contact lenses: aOR, 3.35; 95% CI, 1.62 to 6.92). A higher severity of OSD reported using OSDI has been observed in patients with moderate and severe AD and those with bronchial asthma and rhinitis.

“Clinicians should be aware of the eye symptoms and signs in patients with AD and treat them when they are present, and refer them if necessary,” the researchers concluded. “More research is needed to investigate prognostic factors for the development of OSD in adult patients with AD. “

Reference

Rønnstad ATM, Hansen PM, Halling AS, et al. Factors associated with ocular surface disease and severity in adults with atopic dermatitis: a national survey. J Eur Acad Dermatol Venereol. Published online November 23, 2021. doi: 10.1111 / jdv.17832


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