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Abstract #105769 Published in IGR 23-3
Comparative risk of blindness and vision-threatening ocular comorbidities in patients with Behcet's disease versus the general population
Choi SR; Shin JY; Shin A; Choung H; Woo SJ; Park SJ; Ha YJ; Lee YJ; Lee EB; Park JK; Kang EHRheumatology 2023; 62: 1895-1902
OBJECTIVE: To compare the risk of blindness and vision-threatening ocular comorbidities in patients with Behçet's disease (BD) vs the general population. METHODS: Using 2002-2017 Korea National Health Insurance Service database, we did a population-based cohort study comparing newly-diagnosed BD patients and age- and sex-matched non-BD controls at a 1:5 ratio. The primary outcome was blindness defined as a best-corrected visual acuity of ≤ 20/500 in the better-seeing eye. Secondary outcomes were vision-threatening ocular comorbidities (cataract, glaucoma, and retinal disorders) that require surgical interventions and incident uveitis. Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). We performed subgroup analyses by sex and BD diagnosis age. RESULTS: We included 31 228 BD patients and 156 140 controls. During a follow-up of 9.39 years, the incidence rate of blindness per 1000 person-years was 0.24 in BD and 0.02 in controls with the HR [95% CI] of 10.73 [7.10-16.22]. The HR [95% CI] for secondary outcomes was 2.06 [1.98-2.15] for cataract surgery, 5.43 [4.57-6.45] for glaucoma surgery, and 2.71 [2.39-3.07] for retinal surgery. The HR [95% CI] of incident uveitis was 6.19 [5.83-6.58]. Males suffered a disproportionately higher risk of blindness than females due to greater severity than lower incidence of uveitis. The risk of uveitis and blindness decreased as BD diagnosis ages increased. CONCLUSION: In this large population-based cohort study, BD patients compared with the general population have a 10.73-fold risk of blindness in 10-years and also a substantially higher risk of diverse ocular comorbidities that pose potential threats to vision.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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