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Jeff Huang, Erica B. Jacobs, Emily Seo, Harriet O Lloyd, Kateki Vinod, Tak Yee Tania Tai, Nisha Chadha, Sumayya Ahmad, Douglas Buxton, Robert Ritch, Louis R Pasquale; History of UV-related keratinocytic carcinomas is increased in patients with exfoliation syndrome. Invest. Ophthalmol. Vis. Sci. 2020;61(7):62.
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© ARVO (1962-2015); The Authors (2016-present)
Exfoliation syndrome (XFS) is a systemic disease in which abnormal extracellular matrix deposits are found in the anterior segment of the eye, which can lead to glaucoma (XFG). Increasing evidence has shown that sun exposure in young adulthood is a risk factor for developing XFS. We performed a cross-sectional clinical survey to evaluate whether a history of UV-related carcinomas – basal cell (BCC), and squamous cell (SCC) – was more prevalent in XFS/XFG patients compared to primary open angle glaucoma (POAG) patients and those without glaucoma.
Eligible patients in ophthalmology clinics between the ages of 50-90 were interviewed. POAG/control patients were matched to XFS/XFG patients on the basis of ancestry. We inquired about ancestry, natural eye color, glaucoma diagnosis (type, laterality, date of earliest diagnosis, and family history of glaucoma), likelihood of tanning or burning in the sun, natural hair color at age 18, and diagnosis of SCC/BCC. If patients responded “yes” to any question, they were asked to self-locate the lesion and indicate when and where it was removed and whether a confirmatory biopsy was performed.Univariate analysis was performed with ANOVA. Multivariate logistical regression controlling for age, sex, ancestry, eye color, hair color, tan vs burn, POAG, hypertension, and diabetes was performed comparing SCC/BCC history in XFS vs POAG and controls.
136 patients with mean age of 73.6 ± 9.1 years (51% female; 100% Caucasian) were enrolled (Table 1). In one-way ANOVA, there was a significant difference in history of BCC/SCC among the 3 groups [F(2,133), = 4.85, p = 0.009]. Post hoc analysis showed a nearly two-fold increase in odds of BCC/SCC in XFS/G patients versus controls (44% vs 23% in controls, p=0.03) and versus POAG (19% in POAG patients, p=0.04). In multivariable analysis, XFS/G patients had a significantly increased odds of having either BCC or SCC compared to the combined POAG/control reference group (OR=2.70; 95% CI=1.10-6.6).
Our results show that a history of UV-related keratinocytic carcinomas is increased in XFS/XFG patients versus patients with POAG or patients without glaucoma. This is consistent with the hypothesis that UV exposure in young adulthood is a risk factor for developing XFS/XFG.
This is a 2020 ARVO Annual Meeting abstract.
Table 1. Demographic and medical history data of patients recruited. Total mean age of patients enrolled was 73.6[9.1] years.
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