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Abstract

Importance

Ocular manifestations of polycystic ovarian syndrome (PCOS), particularly related to elevated testosterone, are understudied.

Objective

To evaluate prevalence and odds of ocular diseases in PCOS patients using large-scale electronic health records (EHRs).

Design

Cross-sectional study comparing females aged 15–50 with PCOS (n = 494,557) to two controls: total female population (n = 32,162,331) and BMI ≥30 (n = 4,895,226), based on ICD-10 ocular diagnoses. Prevalence odds ratios (PORs) with 95% confidence intervals were calculated and used to determine statistical significance.

Setting

TriNetX US Collaborative Network, comprising EHRs from 70 healthcare organizations.

Main Outcomes

Prevalence and PORs of 17 ocular conditions in PCOS versus controls.

Results

PCOS patients had higher ocular disease prevalence than both total female (11/17) and high BMI (12/17) groups, and higher PORs. Dry eye (245.63 vs. 129.99 and 105.99 per 10,000) and glaucoma (117.86 vs. 80.39 and 56.44 per 10,000) were significantly more prevalent (p < 0.001). Idiopathic intracranial hypertension, papilledema, diabetic retinopathy (p < 0.001), and several posterior segment diseases also had increased prevalence rates among PCOS patients (p < 0.05).

Conclusion

PCOS is associated with an increased odds of ocular disease independent of BMI. Hormonal and metabolic factors may underlie this relationship and should be further explored.

Keywords

PCOS ocular health testosterone obesity metabolic syndrome dry eye glaucoma

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The impact of polycystic ovarian syndrome on ocular health