Incidence, prevalence, and risk of selected ocular disease in adults with atopic dermatitis

Ocular comorbidities are common in atopic dermatitis (AD) as the result of the disease itself or the use of medication. No large-scale epidemiologic data exist on the prevalence of ocular comorbidities in adults with AD.

We sought to examine the prevalence and risk of selected ocular comorbidities in adult patients with AD.

All Danish individuals ≥18 years of age were linked in nationwide registries. Adjusted hazard ratios (HRs) were estimated by means of Cox regression.

A total of 5766 and 4272 adults were categorized as having mild and severe AD, respectively. At least 1 prescription of anti-inflammatory ocular agents was claimed in 12.0% and 18.9% of patients with mild and severe AD, respectively. In adjusted analysis, the HR of conjunctivitis was 1.48 (95% confidence interval [CI], 1.15-1.90) for mild AD and 1.95 (95% CI, 1.51-2.51) for severe AD. The HR of keratitis was 1.66 (95% CI, 1.15-2.40) for mild AD and 3.17 (95% CI, 2.31-4.35) for severe AD. For adults with severe AD, the HR for keratoconus was 10.01 (95% CI, 5.02-19.96). AD was associated with "cataract only" in individuals <50 years of age.

A limitation of the study is that observational studies cannot establish causality.

Adults with AD had a significant and disease severity-dependent increased risk of development of conjunctivitis, keratitis, and keratoconus compared with that of the general population.