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Abstract：
OBJECTIVE: To investigate the risk of keratoconus (KCN) in patients with atopic keratoconjunctivitis (AKC).
METHODS: This nationwide, retrospective, matched cohort study included 186 202 newly diagnosed AKC patients who were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 372.05, and selected from the Taiwan National Health Insurance Research Database. The age- and sex-matched control group included 186 202 non-AKC patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Patient information was collected between 1 January 2004 and 31 December 2011, and both groups of patients were tracked from the index date until December 2013. The incidence and risk of KCN (ICD-9-CM, code 371.6) were compared between the groups. A Cox proportional hazard regression analysis was performed to obtain the adjusted hazard ratio (HR) for KCN. The cumulative KCN incidence rate was calculated with the Kaplan-Meier analysis.
RESULTS: In total, 62 AKC patients and 26 controls developed KCN during the follow-up period. The incidence rate of KCN was 2.49 times (95% confidence interval [CI] = 1.57-3.93; p < 0.0001) higher in AKC patients than in controls. After adjusting for potential confounders, AKC patients were 2.25 times more likely to develop KCN than controls (adjusted HR, 2.25; 95% CI = 1.41-3.58; p < 0.05).
CONCLUSIONS: Atopic keratoconjunctivitis (AKC) patients had an increased risk of developing KCN. Therefore, AKC patients should be advised of this risk.
METHODS: This nationwide, retrospective, matched cohort study included 186 202 newly diagnosed AKC patients who were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 372.05, and selected from the Taiwan National Health Insurance Research Database. The age- and sex-matched control group included 186 202 non-AKC patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Patient information was collected between 1 January 2004 and 31 December 2011, and both groups of patients were tracked from the index date until December 2013. The incidence and risk of KCN (ICD-9-CM, code 371.6) were compared between the groups. A Cox proportional hazard regression analysis was performed to obtain the adjusted hazard ratio (HR) for KCN. The cumulative KCN incidence rate was calculated with the Kaplan-Meier analysis.
RESULTS: In total, 62 AKC patients and 26 controls developed KCN during the follow-up period. The incidence rate of KCN was 2.49 times (95% confidence interval [CI] = 1.57-3.93; p < 0.0001) higher in AKC patients than in controls. After adjusting for potential confounders, AKC patients were 2.25 times more likely to develop KCN than controls (adjusted HR, 2.25; 95% CI = 1.41-3.58; p < 0.05).
CONCLUSIONS: Atopic keratoconjunctivitis (AKC) patients had an increased risk of developing KCN. Therefore, AKC patients should be advised of this risk.
摘要：
目的：探讨特应性角膜结膜炎（AKC）患者发生圆锥角膜（KCN）的风险。
方法：全国范围内，回顾性,配对队列研究包括186.202例新诊断的AKC患者，这些患者是由国际疾病分类鉴定的，第九次修订,临床修改（ICD-9-CM），代码372.05，并从台湾国民健康保险研究数据库中选取。年龄和性别匹配的对照组包括从台湾纵向健康保险数据库2000中选择的186.202名非AKC患者。在2004年1月1日至2011年12月31日期间收集患者信息，从索引日期到2013年12月对两组患者进行跟踪。KCN的发生率和风险(ICD-9-CM，编号371.6)进行组间比较。进行Cox比例风险回归分析以获得KCN的校正风险比(HR)。用Kaplan-Meier分析计算累积KCN发生率。
结果：总计，62名AKC患者和26名对照在随访期间出现KCN。AKC患者的KCN发生率为对照组的2.49倍（95％置信区间[CI]=1.57-3.93；p<0.0001）。在调整了潜在的混杂因素后，AKC患者发生KCN的可能性是对照组的2.25倍(调整后的HR，2.25；95%CI=1.41-3.58；p<0.05）。
结论：异位性角膜结膜炎（AKC）患者发生KCN的风险增加。因此,应告知AKC患者这种风险。
方法：全国范围内，回顾性,配对队列研究包括186.202例新诊断的AKC患者，这些患者是由国际疾病分类鉴定的，第九次修订,临床修改（ICD-9-CM），代码372.05，并从台湾国民健康保险研究数据库中选取。年龄和性别匹配的对照组包括从台湾纵向健康保险数据库2000中选择的186.202名非AKC患者。在2004年1月1日至2011年12月31日期间收集患者信息，从索引日期到2013年12月对两组患者进行跟踪。KCN的发生率和风险(ICD-9-CM，编号371.6)进行组间比较。进行Cox比例风险回归分析以获得KCN的校正风险比(HR)。用Kaplan-Meier分析计算累积KCN发生率。
结果：总计，62名AKC患者和26名对照在随访期间出现KCN。AKC患者的KCN发生率为对照组的2.49倍（95％置信区间[CI]=1.57-3.93；p<0.0001）。在调整了潜在的混杂因素后，AKC患者发生KCN的可能性是对照组的2.25倍(调整后的HR，2.25；95%CI=1.41-3.58；p<0.05）。
结论：异位性角膜结膜炎（AKC）患者发生KCN的风险增加。因此,应告知AKC患者这种风险。
