Association of Atopic Dermatitis and Risk of Glaucoma Surgery: A Global Population-Based Study

Severe atopic dermatitis in glaucoma patients heightens risk of requiring surgical intervention, necessitating prompt specialist care and strict surveillance. Impact of atopic dermatitis (AD) on the prognosis of glaucoma patients is rarely studied. This study aims to assess the risk of requiring glaucoma surgery among glaucoma patients with and without AD. In this retrospective cohort analysis, we assessed glaucoma patients initially diagnosed from December 5, 2003 to December 3, 2018 using the TriNetX database, dividing them into AD and non-AD cohorts. 1:1 Propensity score matching created balanced groups for baseline traits and comorbidities. We compared the cohorts’ risk and cumulative incidence of needing glaucoma surgery (minimally invasive glaucoma surgery, trabeculectomy, aqueous shunt, or transscleral cyclophotocoagulation). A subgroup analysis was also conducted for patients with severe AD. Out of 528,469 glaucoma patients, 2,624 were in the AD group. Among the AD group, 584 had severe AD. The AD group showed a comparable risk of requiring surgery to the non-AD group (Hazard Ratio [HR]: 1.03; 95% CI: 0.72, 1.47). In contrast, the severe AD group demonstrated a significantly greater risk and cumulative incidence of surgery (HR: 2.80; 95% CI: 1.37, 5.73; log-rank P=0.003) compared to the non-AD group. Glaucoma patients with severe AD are significantly more likely to need surgical intervention, with AD severity being a correlating factor for increased risk.