Risks of glaucoma among individuals with psoriasis: a population-based cohort study

• Published in: Clinical and experimental dermatology Vol. 49; no. 9; pp. 1007 - 1015
• Main Authors: Li, Shu-Hao, Cheng, Chun-Yu
• Format: Journal Article
• Language: English
• Published: UK Oxford University Press 22.08.2024
• Subjects: Adult; Aged; Case-Control Studies; Cohort analysis; Cohort Studies; Female; Glaucoma; Glaucoma - epidemiology; Glaucoma - etiology; Humans; Incidence; Male; Middle Aged; Photochemotherapy; Phototherapy; Population studies; Proportional Hazards Models; Psoralen; Psoriasis; Psoriasis - complications; Psoriasis - drug therapy; Psoriasis - epidemiology; PUVA Therapy - adverse effects; Risk Factors; Taiwan - epidemiology; Young Adult; Taiwan
• ISSN: 0307-6938; 1365-2230; 1365-2230
• DOI: 10.1093/ced/llae073

Abstract Background Psoriasis is a chronic systemic disorder with ocular involvement. Objectives To evaluate the risk of glaucoma among patients with psoriasis. Methods Participants in this cohort study were selected based on Chang Gung Research Database from 1 January 2003 to 31 December 2012. Follow-up ended on 31 December 2017. The participants in the control group were matched with the psoriasis group by sex, age and index date with a 4 : 1 ratio. The hazard ratios of glaucoma were estimated using Cox regression analysis. We also evaluated the relationship between the risk of glaucoma and systemic therapies as well as phototherapy and topical corticosteroid in patients with psoriasis. Results In total, 6682 patients with psoriasis and 26 728 matched controls were enrolled. The study population was composed mainly of males accounting for 64.2% (21 445/33 410) of the study population. The psoriasis group had higher incidence rates than the control group for glaucoma (adjusted hazard ratio 1.405, 95% confidence interval, 1.051–1.879). Patients with psoriasis receiving psoralen–ultraviolet A (PUVA) therapy for > 200 sessions had an increased risk of glaucoma. Conclusions Patients with psoriasis had an increased risk of glaucoma. Long-term PUVA therapy raised the risk of glaucoma in people with psoriasis. Psoriasis is a chronic systemic disorder with ocular manifestations associated with a progressive autoimmune process. To date, few studies have demonstrated a relationship between psoriasis and glaucoma. We conducted a population-based cohort study based on the Chang Gung Research Database and 6682 patients with psoriasis and 26 728 control participants without psoriasis who were matched with the psoriasis group by sex, age and index date, were selected with an average 10-year follow-up period. After adjusting the potential confounders, we demonstrated that patients with psoriasis had an increased risk of incident glaucoma. Regular ophthalmic examinations are recommended for preventing ocular complications in patients.