The risk association between systemic lupus erythematosus and glaucoma: a systematic review and meta-analysis

Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease that may damage multiple organs. About one-third of SLE patients have ocular manifestations. SLE as a potential risk factor for glaucoma has attracted attention, but existing study conclusions remain controversial. This meta-analysis aimed to evaluate the risk association between SLE and glaucoma and provide supportive evidence for the comorbidity follow-up of SLE patients.

The PubMed, EMBASE and Web of Science databases from the establishment of the database to November 2025 were retrieved, and studies measuring the association between SLE and glaucoma risk by hazard ratio (HR), odds ratio (OR), relative risk (RR), incidence rate ratio (IRR) and 95% confidence interval (CI) were included. Two researchers independently screened the literature, extracted the data and evaluated the risk of bias in the included studies. Meta-analysis was conducted using RevMan 5.3 software.

Five cohort studies were included, involving 5516709 participants. Meta-analysis showed that SLE was associated with an increased risk of glaucoma (OR = 2.85, 95% CI: 1.26-6.47, P = 0.01). Subgroup analyses showed stronger associations in studies with fewer covariate adjustments and in those that did not adjust for corticosteroid use.

Existing evidence suggests that SLE may be associated with an increased risk of glaucoma. Given the limitations of this study, more prospective studies with rigorous design and full control of confounding factors are needed for further verification.

https://www.crd.york.ac.uk/prospero, identifier CRD420261303001.