Diabetic Patients With Rosacea Increase the Risks of Diabetic Macular Edema, Dry Eye Disease, Glaucoma, and Cataract

Abstract

Purpose: Inflammation plays a role in diabetic eye diseases, but the association between rosacea and eye diseases in patients with diabetes remains unknown. Design: This retrospective cohort study used claims data from the National Health Insurance Research Database in Taiwan to investigate the association between rosacea and eye diseases in patients with diabetes. Materials and Methods: Taiwanese patients diagnosed as having diabetes mellitus between January 1, 1997, and December 31, 2013, and using any hypoglycemic agents were included and divided into rosacea and nonrosacea groups. After applying 1:20 sex and age matching and exclusion criteria, 1:4 propensity score matching (PSM) was conducted to balance the covariate distribution between the groups. The risk of time-to-event outcome between rosacea and nonrosacea groups in the PSM cohort was compared using the Fine and Gray subdistribution hazard model. Results: A total of 4096 patients with rosacea and 16,384 patients without rosacea were included in the analysis. During a mean follow-up period of 5 years, diabetic patients with rosacea had significantly higher risks of diabetic macular edema [subdistribution hazard ratio (SHR): 1.31, 95% confidence interval (CI): 1.05–1.63], glaucoma with medical treatment (SHR: 1.11, 95% CI: 1.01–1.21), dry eye disease (SHR: 1.55, 95% CI: 1.38–1.75), and cataract surgery (SHR: 1.13, 95% CI: 1.02–1.25) compared with diabetic patients without rosacea. A cumulative incidence analysis performed up to 14 years after the index date revealed that the risks of developing ocular diseases consistently increased over time. No significant differences in diabetic retinopathy, age-related macular degeneration, retinal vascular occlusion, ischemic optic neuropathy, optic neuritis, uveitis, or retinal detachment were identified according to rosacea diagnosis. However, we observed significant associations between rosacea and psoriasis, irritable bowel syndrome, anxiety, and major depressive disorder among patients with diabetes. Conclusions: Rosacea is associated with diabetic macular edema, glaucoma, dry eye disease, and cataract development in diabetic patients, as well as increased risks of psoriasis, irritable bowel syndrome, anxiety, and depression in diabetic patients.

An Efficient System for Diagnosis of Human Blindness Using Image-Processing and Machine-Learning Methods

“…The contemporary human lifestyle is thought to be one of the main causes of numerous health disorders, such as diabetes mellitus, which can impair functioning of critical human body organs, such as the kidneys, heart, and eyes. Prolonged diabetes can lead to eye disorders and diseases, including Diabetic Retinopathy (DR), Diabetic Maculopathy (DM), and glaucoma [1]. These eye diseases are the leading An Efficient System for Diagnosis of Human Blindness Using Image-Processing and Machine-Learning Methods causes of blindness worldwide.…”

Increased Risk of Glaucoma in Patients with Rosacea: A Nationwide Population-Based Cohort Study

“…Ocular rosacea can be overlooked by physicians [9] because the severity of clinical symptoms and signs of ocular rosacea do not usually correlate with those of facial rosacea [10]. Nevertheless, ocular rosacea is often comorbid in patients with facial rosacea, and some studies have confirmed the possible association of various ophthalmologic disorders other than manifestations of ocular rosacea in patients with rosacea [11,12].…”