Causal Associations Between Socioeconomic Status and Corneal Diseases: A Multivariate Mendelian Randomisation Study

To investigate the causal relationship between socioeconomic status (SES) and corneal diseases.

Two-sample Mendelian randomisation (MR) analysis. Place and Duration of the Study: Department of Pharmacy, Eye Hospital, Wenzhou Medical University, Wenzhou, China, between May and September 2024.

The genome-wide significant single-nucleotide polymorphisms (SNPs) (p <5 × 10-8) associated with educational attainment, household income, and occupational status were selected as instrumental variables (IVs). Linkage disequilibrium (LD) clumping (r2 <0.001) was applied to ensure independence, and SNPs with F-statistics <10 were excluded. Corneal disease outcomes were analysed using inverse variance weighting (IVW) as the primary method. Sensitivity analyses, including Cochran's Q-test for heterogeneity, the MR-Egger for interception, and MR-PRESSO for pleiotropy, were performed to assess robustness.

A significant negative association was observed between educational attainment and corneal ulcer risk in the univariate MR analysis (IVW OR, 0.77; 95% CI: 0.66-0.92; p = 0.003). In the multivariate MR (MVMR) analysis adjusting for household income and educational attainment, occupational status showed a significant association with corneal ulcer risk (IVW OR, 0.91; 95% CI: 0.82-0.99; p = 0.041). No significant associations were observed with other subtypes of corneal diseases.

These findings indicate that genetic evidence that lower socioeconomic status, particularly lower educational attainment and occupational status, is associated with an increased risk of corneal ulcer. Targeted public health strategies to improve socioeconomic conditions in disadvantaged populations may help reduce the burden of corneal diseases.

Socio-economic status, Corneal diseases, Mendelian randomisation, Corneal ulcers.