Allergic diseases increase cataract risk, especially among men younger than 50 years
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Key takeaways:
- Allergic diseases were associated with a heightened risk for cataract surgery.
- Men aged younger than 50 years and those with a combination of allergic diseases were most at risk.
People with allergic diseases had an increased risk for cataract surgery, an association more evident in men aged younger than 50 years and in those with both atopic dermatitis and allergic rhinitis, according to data in Scientific Reports.
“This result is unexpected, as previous studies have found that atopic dermatitis and respiratory allergy predominantly affect women after adolescence, following the start of menarche,” Ji-Sun Paik, MD, of the department of ophthalmology at The Catholic University of Korea College of Medicine, and colleagues wrote.
In a nationwide, population-based cohort study, researchers evaluated the association between the risk for visually threatening cataracts and allergic diseases using data from 2,631,015 individuals in the National Health Insurance Service-National Sample Cohort database in Korea, of whom 301,693 underwent cataract surgery in at least one eye, and 447,883 had at least one allergy. Allergic diseases included in the investigation were atopic dermatitis, allergic rhinitis and asthma.
Researchers also categorized participants into the following four groups to adjust for sex and age: men and women aged at least 50 years and men and women aged younger than 50 years.
After a mean follow-up of 7.8 years, Paik and colleagues reported that individuals with allergic diseases had a higher risk for cataract surgery than individuals without allergic diseases (HR = 1.241).
Among those with atopic dermatitis, men aged younger than 50 years had a higher risk for cataract surgery (HR = 1.713) than men aged 50 years and older (HR = 1.42), women aged younger than 50 years (HR = 1.326) and women aged 50 years and older (HR = 1.193).
Additionally, the combination of atopic dermatitis and allergic rhinitis yielded the highest risk for cataract surgery, according to researchers.
“Adult patients with atopic dermatitis, especially middle-aged men, require screening for a combination of other allergic conditions and regular ophthalmologic examination for the future risk of cataract,” Paik and colleagues wrote.
Perspective
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Zoe Phillips Connacher, OD, FAAO
Pollen season is starting earlier and lasting longer, and we are seeing an increase in the incidence of atopic dermatitis, allergic rhinitis and asthma — also known as the atopic triad. The atopic triad among patients has consistently increased in prevalence over the last few decades, and these patients find their way to our chair with a myriad of ocular symptoms. This is an interesting study linking the increased risk of cataract surgery in patients diagnosed with allergic disease, which has been studied previously with conflicting data. The study ultimately found that young (<50 years old) male subjects with allergic disease were at an increased risk of visually affected cataracts over their counterparts.
This was a population-based cohort study of data derived from the 2009 National Health Insurance Service-Health Screening Cohort in Korea. There was a high participation rate, including a large cohort of men and women with stable multiple-year follow-ups, which can strengthen a study, although we must remember that the conclusions were limited to a single race in a single country and might not be generalizable to all populations. There was also a possibility of misclassification bias, under-reporting or over-reporting due to the fact that the subjects were defined based solely on ICD-10 diagnostic codes. We also know that history of steroid treatment for allergic disease — systemic, intranasal or topical — is associated with cataract formation, and this was not considered in the data analysis.
Overall, this study highlights the long-term effects of allergic disease, reminding us to provide comprehensive and routine eye care to these patients that fall within the atopic triad.
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