Is Pediatric Atopic Dermatitis Associated With Cataract?
JAMA Ophthalmology, August 2018
Atopic dermatitis (AD) is a common chronic inflammatory skin disease that affects up to 20% of children in industrialized countries. Although the condition has been linked to various ocular complications, whether pediatric AD is associated with cataract is unknown. Jeon et al. investigated this matter in a Korean pediatric population. They found that, although the association appears to be rare, pediatric AD carries a higher-than-normal risk for cataract surgery.
For this population-based retrospective longitudinal study, the authors extracted nationally representative data from the Korean National Health Insurance Service database for a 12-year period (2002-2013).
Each incident case of AD or severe AD in a person <20 years of age was matched to 4 controls, using propensity scores derived from age, sex, residential area, and household income. Main outcome measures were incidence probabilities of cataract development and cataract surgery for patients with AD and controls, which were compared using Kaplan-Meier methods and log-rank tests. Cox proportional hazard models, fitted for cataract and cataract surgery, were applied to determine risk factors in the matched cohort.
Among the 34,375 patients with incident AD (mean age, 3.47; 47% female), severe AD was present in 3,734 (10.9%). The total number of matched controls was 137,500. The incidence of cataract development was similar for the AD and control groups (0.216% vs. 0.227%) and for patients with severe AD and their controls (0.520% vs. 0.276%).
Cataract surgery was performed more frequently in the AD cohort than in the control group (0.075% vs. 0.041%) and more often in patients with severe AD than their controls (0.221% vs. 0.070%). Severe AD was associated with cataract development and the need for cataract surgery.
The authors concluded that the absolute risk of cataract is rare, with or without AD. However, their findings suggest that patients with AD are more likely to require surgery for cataract and that this is particularly true for those with severe AD.
The original article can be found here.