Association of Atopic Dermatitis and Risk of Glaucoma Surgery: A Global Population-Based Study

J Glaucoma. 2024 Oct 1;33(10):735-741. doi: 10.1097/IJG.0000000000002464. Epub 2024 Jul 19.

Abstract

Prcis: Severe atopic dermatitis (AD) in patients with glaucoma heightens the risk of requiring surgical intervention, necessitating prompt specialist care and strict surveillance.

Objective: The impact of AD on the prognosis of patients with glaucoma is rarely studied. This study aims to assess the risk of requiring glaucoma surgery among patients with glaucoma with and without AD.

Materials and methods: In this retrospective cohort analysis, we assessed patients with glaucoma initially diagnosed from December 5, 2003 to December 3, 2018 using the TriNetX database, dividing them into AD and non-AD cohorts. 1:1 propensity-score matching created balanced groups for baseline traits and comorbidities. We compared the cohorts' risk and cumulative incidence of needing glaucoma surgery (minimally invasive glaucoma surgery, trabeculectomy, aqueous shunt, or transscleral cyclophotocoagulation). A subgroup analysis was also conducted for patients with severe AD.

Results: Out of 528,469 patients with glaucoma, 2624 were in the AD group. Among the AD group, 584 had severe AD. The AD group showed a comparable risk of requiring surgery to the non-AD group (hazard ratio: 1.03; 95% CI: 0.72, 1.47). In contrast, the severe AD group demonstrated a significantly greater risk and cumulative incidence of surgery (hazard ratio: 2.80; 95% CI: 1.37, 5.73; log-rank P = 0.003) compared with the non-AD group.

Conclusion: Patients with glaucoma with severe AD are significantly more likely to need surgical intervention, with AD severity being a correlating factor for increased risk.

MeSH terms

  • Adult
  • Aged
  • Dermatitis, Atopic* / complications
  • Dermatitis, Atopic* / epidemiology
  • Dermatitis, Atopic* / surgery
  • Female
  • Glaucoma Drainage Implants
  • Glaucoma* / complications
  • Glaucoma* / epidemiology
  • Glaucoma* / surgery
  • Global Health
  • Humans
  • Incidence
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Trabeculectomy*