Lichen Simplex Chronicus is Associated with an Increased Risk of Rhegmatogenous Retinal Detachment and Retinal Tears: A Propensity Score-Matched Cohort Study

To determine whether lichen simplex chronicus (LSC) is associated with an increased risk of rhegmatogenous retinal detachment (RRD) and retinal tears without detachment (RT) compared with adults without LSC.

This retrospective propensity score-matched cohort study used TriNetX to compare adults (≥18 years) with LSC to matched adults without LSC. Patients with prior RRD, RT, ocular trauma, or proliferative diabetic retinopathy were excluded. Propensity score matching (1:1) was performed on demographics, ocular and systemic comorbidities, and prior ophthalmology encounters. Incidence of RRD, RT, the composite endpoint of RRD or RT (RRD/RT), retinopexy, RRD repair, and the composite of RRD repair or retinopexy were compared using risk analysis and Kaplan-Meier survival analysis with Cox regression, yielding risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI).

After 1:1 propensity score matching, the study included 64,170 patients per group. LSC patients had significantly higher rates of RRD (RR 8.83, 95% CI 4.86-16.05; p<0.001), RT (RR 10.15, 95% CI 6.79-15.19; p<0.001), and composite RRD/RT (RR 9.60, 95% CI 6.78-13.60; p<0.001). On procedure analysis, retinopexy (RR 6.64, 95% CI 3.52-12.51; p<0.001), RRD repair (RR 4.07, 95% CI 2.27-7.31; p<0.001), and the composite of retinopexy or RRD repair (RR 5.08, 95% CI 3.28-7.87; p<0.001) occurred more frequently in the LSC cohort.

LSC is associated with a substantially increased risk of incident diagnosis of RRD, RT, composite RRD/RT, and their procedural repair after adjustment for known risk factors. These findings suggest LSC may increase the risk of rhegmatogenous retinal pathology.