Abstract
Purpose :
Atopic dermatitis (AD) in adulthood may have shared mechanisms with age-related macular degeneration (AMD) regarding complement activation, increased oxidative stress, and systemic inflammation. We performed a retrospective, observational clinical study to test the hypothesis that adult AD patients may have a higher risk of developing AMD.
Methods :
This study analyzed nineteen years of longitudinal data from Taiwan's National Health Insurance Research Database (2000-2018). AD patients, aged 50 and above with no pre-existing AMD were included. Non-AD individuals were recruited by 1:1 matching for age, sex and index year. A propensity score matching was used to reduce the systematic differences in baseline characteristics between the paired groups. A Cox regression model was used to estimate hazard ratio (HR) for AMD. Individual outcome analyses were conducted for dry and wet AMD. Stratified analyses according to age, sex, and AD activity were also performed.
Results :
Our analysis included a total of 20,732 subjects, with 10,366 subjects in each AD and non-AD cohort. Compared to controls, adults with AD had a significantly increased risk of incident AMD (HR 1.25; 95% CI 1.11–1.41). Individual outcome analyses revealed that AD was associated with higher risks of dry AMD (HR 1.26; 95% CI 1.12–1.42) but not wet AMD (HR 1.08; 95% CI 0.73–1.61). There were increased risks of AMD in association with adult AD in different groups stratified by age and sex. Regarding the AD activity, a significantly increased risk of AMD in patients with AD was observed only in the group of predominantly active AD (HR 4.04, 95% CI: 2.62–6.24) but not in that of the less active AD (HR 1.13, 95% CI: 0.99–1.28).
Conclusions :
Our study suggests an increased risk of AMD in adult AD patients, particularly in those with predominantly active AD. These findings emphasize the importance of collaborative efforts between ophthalmologists and dermatologists when caring for adults with AD. Since early AMD may not exhibit symptomatology, proactive inquiries by dermatologists and thorough examinations by ophthalmologists are essential to the early detection of AMD in AD adults. Future research is warranted to elucidate the pathophysiology linking AD and AMD.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.