Incidence of glaucoma in patients with systemic lupus erythematosus: a nationwide cohort study in South Korea

Abstract

Background/aims To assess the incidence of glaucoma in patients with systemic lupus erythematosus (SLE) and to identify associated risk factors using a nationwide population-based cohort. Methods This retrospective cohort study analysed data from the Korean National Health Insurance Service (2008-2022). A total of 9682 patients with SLE were identified using ICD-10 code M32 and rare intractable disease code V136 and matched 1:1 to non-SLE controls by age and sex. The incidence of glaucoma (ICD-10 codes H40 and H42) and glaucoma suspect (H40.0) was assessed. Multivariate logistic regression was used to identify risk factors for glaucoma, including long-term corticosteroid use (>= 180 days). Results The incidence of glaucoma was significantly higher in the SLE group than in controls (11.34% vs 3.74%; p<0.0001), with a greater prevalence in younger patients (<40 years) and females. Glaucoma suspect cases were also more common in the SLE group (35.56% vs 30.25%; p<0.0001). SLE was independently associated with glaucoma (adjusted OR: 2.00, 95% CI 1.69 to 2.38), and prolonged corticosteroid use further increased the risk (OR: 1.75, 95% CI 1.51 to 2.02). Annual incidence trends showed a rising pattern over time, especially among SLE patients. Conclusions SLE is associated with an increased risk of glaucoma, particularly among younger individuals and females. Prolonged corticosteroid therapy significantly contributes to this risk. These findings support the need for regular ophthalmic screening and judicious corticosteroid management in patients with SLE.