Disclosures: The authors report no relevant financial disclosures.
November 05, 2021
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Retinal diseases associated with alopecia areata

Disclosures: The authors report no relevant financial disclosures.
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Retinal diseases were more prevalent in patients with alopecia areata, which could lead these patients to being more at-risk for retinal detachment or retinal arterial occlusion, according to a study.

“Alopecia areata (AA) is a common autoimmune disorder of the hair which has an estimated lifetime risk of 1.7%,” Hui-Chu Ting, MD, of the department of dermatology at Taipei Veterans General Hospital in Taiwan, and colleagues wrote. “Several studies have described the abnormalities or changes in retinal structure in patients with AA, including retinal alterations in the form of pigmentary clumping, choroidal sclerosis and macular degeneration.”

These studies, however, have mostly been limited to case reports without comparison groups, which failed to determine the relationship between AA and retinal disorders.

Researchers conducted a nationwide population-based cohort study using data from the National Health Insurance Research Database in Taiwan.

Patients with AA were identified and matched 1:10 for age, sex, monthly premium, residence and comorbidities, with controls.

Of the 9,909 patients with AA, retinal detachment was developed in 61 subjects, with an overall rate of 81.85 cases per 100,000 person-years. This compared with 175 of the 99,090 control subjects, with an overall rate of 23.38 cases per 100,000 person-years.

Adjusted HR for retinal diseases in AA patients was 2.96 (95% CI, 2.2-3.98) compared with controls.

In addition to retinal detachment (aHR = 3.8; 95% CI, 1.97-7.31), AA patients had a significantly higher rate of developing retinal vascular occlusion (aHR = 2.14; 95% CI, 1.09-4.19) and retinopathy (aHR = 3.18; 95% CI, 2.21-4.57).

In addition, the risk of retinal disease in AA patients was larger in those aged 20 to 49 years, as well as in those who had taken systemic corticosteroids for 30 days or longer.

The study did not determine the pathogenesis or mechanism of AA and how it is connected to retinal diseases, which the authors suggest further studies evaluate.

“This large population-based cohort study found that patients with AA had a significantly higher risk of retinal diseases, including retinal detachment, retinal vascular occlusion and retinopathy, than controls,” the authors wrote. “Further studies are needed to clarify the mechanism of retinal diseases in patients with AA.”