Atopic disease and astigmatism: a population-based study.

OBJECTIVES

To assess the relationship between atopic disease and astigmatism in adolescence and young adulthood.

METHODS

In this population-based cross-sectional study 897,811 medical records of Israeli adolescents and young adults without keratoconus were reviewed. The prevalence of low-to-moderate (3.00 > D ≥ 0.75) and high ( ≥ 3.00 D) astigmatism were calculated in cases with and without atopic disease, including ocular atopic disease (OAD), asthma, allergic rhinitis, atopic dermatitis, angioedema/urticaria, and history of anaphylaxis. Relationships were analysed using multinominal logistic regression, with adjustments for relevant sociodemographic factors.

RESULTS

A total of 897,811 adolescents were included in the analysis (mean age 17.2 ± 0.8 years, 57.8% men). OAD was found in 4702 individuals, with a prevalence of 0.5%. Adolescents with OAD demonstrated a gradual increase in odds ratio (OR) for low-to-moderate and for high astigmatism (OR 1.16, 95% CI 1.07-1.27 and OR 2.10, 95% CI 1.63-2.70, respectively). This group also showed increased OR for with-the-rule astigmatism (OR 1.34, 95% CI 1.21-1.48). Other atopic diseases were associated with more modest ORs for low-to-moderate (OR 1.09, 95% CI 1.07-1.11) and for high astigmatism (OR 1.10, 95% CI 1.02-1.19), persisting across all axis orientations. Sensitivity analysis revealed a dose-response relationship between OAD severity and astigmatism, and consistent point estimates in a group of 1331 adolescents diagnosed with OAD during military service.

CONCLUSIONS

This study establishes an association between OAD and astigmatism, highlighting the importance of effective OAD management. Further research into tailored therapeutic interventions that address both conditions concurrently is needed.