Abstract
Purpose :
To assess the lifetime associations between various ocular conditions in patients with substance use disorders, including alcohol, cannabis, opioid, and nicotine related disorders, from the time of diagnosis.
Methods :
We conducted a retrospective cohort study using TriNetX, a national, federated database that provides aggregate electronic health record data from 80 million unique patient files within 56 healthcare organizations. Patients diagnosed with substance use disorders (SUD) were identified using ICD-10 diagnostic codes and followed for subsequent diagnoses of 27 ocular conditions over the span of a patient’s lifetime after initial diagnosis of substance use disorder. The primary outcomes were incidence, as listed in Table 1. Patients with pre-existing ocular disease were excluded from this analysis.
Results :
A total of 7,546,278 patients were included with 1,460,831 diagnosed with alcohol use disorders (AUD), 775,891 with cannabis use disorders (CUD), 573,583 with opioid use disorders (OUD), and 4,753,973 with nicotine dependence (ND). 37% (10/27) of ocular diagnoses had the same incidence between each SUD cohort. AUD had the most diagnoses with the highest incidence (48%) and CUD had the most diagnoses with the lowest incidence (63%). AUD had the highest incidence of disorders of refraction and accommodation (3.1%), glaucoma (1.4%), and cataract (1.4%). CUD had the lowest incidence of cystoid macular degeneration (0%), puckering of macula (0.1%), and retinal vascular occlusion (0.1%). OUD had the highest incidence of strabismus (0.3%) and dry eye syndrome (1.5%) and lowest incidence of retinal vascular occlusion (0.1%). ND had the highest incidence of conjunctivitis (2.1%), glaucoma (1.4%), and cataract (1.4%). The incidence of glaucoma, cataracts, macular degeneration, blindness, and disorders of refraction and accommodation were higher among patients with alcohol and nicotine use disorders than cannabis and opioid use disorders. The incidence of dry eye syndrome was highest among patients with opioid use disorders while the incidence of conjunctivitis was highest among those with nicotine use disorders.
Conclusions :
This the first national-scale study that sheds light on the associations between substance use disorder and the most common ocular diseases. These findings can be useful when examining a patient with a history of SUD.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.