Association of Dry Eye and Corneal Ulcers With Collagen Vascular Diseases in a Medicare Population.

Purpose: There is a lack of research on the extent to which non-Sjögren collagen vascular diseases affect the ocular surface. This study aims to understand the associations between collagen vascular diseases and dry eye and corneal ulcers.

Methods: This study analyzed a random 5% sample of national Medicare beneficiaries from 2011 to 2015 and included claims for those with collagen vascular diseases and either dry eye or corneal ulcers (n = 2,688,114). Two multivariable logistic regression models assessed the outcomes of dry eye and corneal ulceration, considering age, sex, race, and collagen vascular diseases as exposure variables.

Results: A total of 219,352 patients with dry eye and 4366 patients with corneal ulcer were identified. Various collagen vascular diseases exhibited distinct associations with dry eye (primary Sjögren's: [odds ratio (OR) 9.67], [95% confidence interval (CI) = 9.06 to 10.31]; secondary Sjögren's: OR 3.92, 95% CI = 3.64 to 4.21; rheumatoid arthritis: OR 2.43, 95% CI = 2.37 to 2.48; systemic sclerosis: OR 2.12, 95% CI = 1.91 to 2.36). Corneal ulcers also had an association with rheumatologic diseases (primary Sjögren's: OR 6.26, 95% CI = 4.48-8.47; secondary Sjögren's: OR 3.59, 95% CI = 2.63-4.81; rheumatoid arthritis: OR 3.34, 95% CI = 2.95-3.76; psoriatic arthritis: OR 1.64, 95% CI = 1.01-2.49).

Conclusions: The strong association between collagen vascular disease and dry eye and corneal ulcers necessitates an interdisciplinary approach with close collaboration between rheumatologists and ophthalmologists in the diagnosis and management of systemic inflammatory diseases.