The Correlation Between Aortic Stenosis and the Incidence of Subsequent Ocular Surface Diseases

Aortic stenosis (AS) is a fatal cardiovascular disease associated with metabolic syndrome and inflammation. Ocular surface diseases are also characterized by elevated inflammatory responses. Therefore, this study aimed to investigate the correlation between AS and the subsequent development of ocular surface diseases, including dry eye disease (DED) and superficial keratopathy.

A retrospective cohort study was performed via the usage of the TriNetX database. The patients were divided according to the presence of AS and a total of 421,253 patients were enrolled into both the AS and non-AS groups. The primary outcomes were the development of DED and superficial keratitis after AS. The Cox proportional hazard regression was applied to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of primary outcomes between groups.

There were 11,915 and 8,260 DED episodes in the AS and the non-AS groups, respectively. Also, there were 1,409 and 1,038 superficial keratopathy events in the AS and non-AS groups, respectively. After adjusting for all the confounders, the AS group showed a significant higher incidence of DED (aHR=1.375, 95%CI=1.337-1.414, p<0.001) and superficial keratopathy (aHR=1.286, 95%CI=1.187-1.393, p<0.001) compared to the non-AS group. The cumulative incidences of DED and superficial keratopathy were also significantly higher in the AS group than in the non-AS group (both p<0.001). In subgroup analyses, the risk of ocular surface diseases was significantly higher in all AS subgroups except the Asian population.

The presence of AS associates with a higher risk of subsequent DED and superficial keratopathy development, which positively relate to the duration of AS.