ArticleBMJ open2025
Risk of cataract in patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo investigate whether systemic lupus erythematosus (SLE) increases the risk of cataract development and to evaluate the impact of corticosteroid use and dosage on this risk.
designNationwide retrospective cohort study.
settingUsing Taiwan's National Health Insurance (NHI) database, which covers over 99.9% of the population.
participantsThe SLE cohort included 30 501 newly diagnosed adults from 2011 to 2020. For each patient with SLE, four individuals without SLE were selected from the NHI database using frequency matching by age (in 5 year intervals), gender and index year of diagnosis, resulting in a comparison cohort of 122 004 individuals. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was incident cataract. Secondary outcomes included risk stratification by age, sex, comorbidities and corticosteroid dose.
resultsSLE patients had a higher incidence of cataracts than non-SLE individuals (adjusted HR (aHR) = 1.73, 95% CI 1.66 to 1.81). Stratified analyses showed elevated risks in women (aHR=1.74, 95% CI 1.66 to 1.83), men (aHR=1.68, 95% CI 1.52 to 1.86), and across age groups 20-49 years (aHR=2.32, 95% CI 2.11 to 2.56), 50-64 years (aHR=1.60, 95% CI 1.51 to 1.69), and ≥65 years (aHR=1.50, 95% CI 1.36 to 1.66). Analysis of corticosteroid exposure revealed that cumulative dose showed a trend towards increased risk at high exposure (adjusted OR (aOR) = 1.14, 95% CI 0.99 to 1.31), while average daily dose demonstrated a dose-response effect: 1-5 mg/day (aOR=1.31, 95% CI 1.13 to 1.52) and ≥5 mg/day (OR=2.48, 95% CI 2.16 to 2.86).
conclusionsAdults with SLE have an increased risk of developing cataracts compared with matched controls, and higher average daily corticosteroid doses are associated with this risk. These findings highlight the need for careful monitoring of ocular complications in SLE patients.
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