The systemic effects and comorbidities of psoriasis include ocular disorders, such as uveitis. Patients with psoriatic arthritis in particular have been demonstrated to have an elevated risk for developing uveitis. Presently, the risk of uveitis in psoriasis has yet to be fully elucidated and this systematic review seeks to address this gap.
Objective
To examine the prevalence and incidence of uveitis in psoriasis patients compared to non-psoriasis patients.
Methods
We conducted a systematic review search on MEDLINE, Embase, and CENTRAL electronic databases with no lower limit on year of publication.
Results
Fourteen articles met our inclusion criteria, with a total of 234 143 psoriasis subjects. Two studies found that participants with severe psoriasis were at a greater risk of uveitis than those with mild psoriasis. A random-effects meta-analysis of the 3 studies, which reported risk of incidence of uveitis in psoriasis patients compared to non-psoriasis controls, found a pooled risk ratio of 1.29 (95% CI, 1.10-1.51), indicating an increased risk of uveitis in psoriasis. Three studies compared risk of uveitis in psoriatic arthritis with psoriasis-only participants, all finding that psoriatic arthritis was associated with a greater risk of uveitis.
Conclusions
In summary, our findings suggest that psoriasis is associated with an increased risk of uveitis, with or without psoriatic arthritis.
ChiC-C.WangJ.ChenY-F.WangS-H.ChenF-L.TungT-H. Risk of incident chronic kidney disease and end-stage renal disease in patients with psoriasis: a nationwide population-based cohort study. J Dermatol Sci. 2015;78(3):232-238.doi:10.1016/j.jdermsci.2015.03.012http://www.ncbi.nlm.nih.gov/pubmed/25862150
2.
YangH-J.YangK-C. Impact of psoriasis on quality of life in Taiwan. Dermatologica Sinica. 2015;33(3):146-150.doi:10.1016/j.dsi.2015.02.001
3.
YangT-S.ChiC-C.WangS-H.LinJ-C.LinK-M. Cost-efficacy of biologic therapies for psoriatic arthritis from the perspective of the Taiwanese healthcare system. Int J Rheum Dis. 2016;19(10):1002-1009.doi:10.1111/1756-185X.12744http://www.ncbi.nlm.nih.gov/pubmed/26404916
4.
AbboudaA.AbiccaI.FabianiCet al. Psoriasis and psoriatic arthritis-related uveitis: different Ophthalmological manifestations and ocular inflammation features. Semin Ophthalmol. 2017;32(6):715-720.doi:10.3109/08820538.2016.1170161http://www.ncbi.nlm.nih.gov/pubmed/27419848
5.
FragaNAdeA.OliveiraMdeFPde.FolladorI.RochaBdeO.RêgoVR. Psoriasis and uveitis: a literature review. An Bras Dermatol. 2012;87(6):877-883.doi:10.1590/s0365-05962012000600009http://www.ncbi.nlm.nih.gov/pubmed/23197207
6.
AjitsariaR.DaleR.FergusonV.MayouS.CavanaghN.PsoriasisCN. Psoriasis, psoriatic arthropathy and relapsing orbital myositis. Clin Exp Dermatol. 2001;26(3):274-275.doi:10.1046/j.1365-2230.2001.00814.xhttp://www.ncbi.nlm.nih.gov/pubmed/11422174
7.
DeschenesJMurrayPIRaoNANussenblattRBInternational Uveitis Study Group. International uveitis Study Group (IUSG): clinical classification of uveitis. Ocul Immunol Inflamm. 2008;16(1):1-2.doi:10.1080/09273940801899822http://www.ncbi.nlm.nih.gov/pubmed/18379933
8.
JabsDANussenblattRBRosenbaumJTStandardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the first International workshop. Am J Ophthalmol. 2005;140(3):509-516.doi:10.1016/j.ajo.2005.03.057http://www.ncbi.nlm.nih.gov/pubmed/16196117
9.
DurraniK.FosterCS. Psoriatic uveitis: a distinct clinical entity?Am J Ophthalmol. 2005;139(1):106-111.doi:10.1016/j.ajo.2004.08.053http://www.ncbi.nlm.nih.gov/pubmed/15652834
10.
WellsGS.O’ConnellD. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa Health Research Institute. Published 2019. www.ohri.ca/programs/clinical_epidemiology/oxford.asp
11.
ErbagciI.ErbagciZ.GungorK.BekirN. Ocular anterior segment pathologies and tear film changes in patients with psoriasis vulgaris. Acta Med Okayama. 2003;57(6):299-303.doi:10.18926/AMO/32810http://www.ncbi.nlm.nih.gov/pubmed/14726967
12.
LindegardB. Diseases associated with psoriasis in a general population of 159,200 middle-aged, urban, native Swedes. Dermatologica. 1986;172:298-304.
13.
ChowdhuryB.PavaiyaA.KhuranaVK. Ocular findings in psoriasis patients. Int J Contemp Med Res ISSN. 2017;4(10):2393-2915. www.ijcmr.com
14.
AbbaganiS.KamathYS.NayakS. A study on ocular morbidity among patients with psoriasis visiting a tertiary care hospital in Karnataka, southern India. Ocul Immunol Inflamm. 2019;27(4):531-534.doi:10.1080/09273948.2017.1414271http://www.ncbi.nlm.nih.gov/pubmed/29286864
15.
Catsarou-CatsariA.KatsambasA.TheodoropoulosP.StratigosJ. Ophthalmological manifestations in patients with psoriasis. Acta Derm Venereol. 1984;64(6):557-559.http://www.ncbi.nlm.nih.gov/pubmed/6084935
16.
ChandranNS.GreavesM.GaoF.LimL.ChengBCL. Psoriasis and the eye: prevalence of eye disease in Singaporean Asian patients with psoriasis. J Dermatol. 2007;34(12):805-810.doi:10.1111/j.1346-8138.2007.00390.xhttp://www.ncbi.nlm.nih.gov/pubmed/18078405
17.
CharltonR.GreenA.ShaddickGet al. Risk of uveitis and inflammatory bowel disease in people with psoriatic arthritis: a population-based cohort study. Ann Rheum Dis. 2018;77(2):277-280.doi:10.1136/annrheumdis-2017-212328http://www.ncbi.nlm.nih.gov/pubmed/29092855
18.
ChiC-C.TungT-H.WangJet al. Risk of uveitis among people with psoriasis: a nationwide cohort study. JAMA Ophthalmol. 2017;135(5):415-422.doi:10.1001/jamaophthalmol.2017.0569http://www.ncbi.nlm.nih.gov/pubmed/28418500
19.
da CruzNFS.BrandãoLS.da CruzSFS.da CruzSAS.PiresCAA.CarneiroFRO. Ocular manifestations of psoriasis. Arq Bras Oftalmol. 2018;81(3):219-225.doi:10.5935/0004-2749.20180044http://www.ncbi.nlm.nih.gov/pubmed/29924189
20.
EgebergA.KhalidU.GislasonGH.MallbrisL.SkovL.HansenPR. Association of psoriatic disease with uveitis: a Danish nationwide cohort study. JAMA Dermatol. 2015;151(11):1200-1205.doi:10.1001/jamadermatol.2015.1986http://www.ncbi.nlm.nih.gov/pubmed/26222707
21.
JainVK.SoodS.PahwaUS.AhluwaliaBK. Ocular lesions in psoriatics. Indian J Dermatol Venereol Leprol. 1987;53(1):33-34.http://www.ncbi.nlm.nih.gov/pubmed/28145297
22.
KilicB.DoganU.ParlakAHet al. Ocular findings in patients with psoriasis. Int J Dermatol. 2013;52(5):554-559.doi:10.1111/j.1365-4632.2011.05424.xhttp://www.ncbi.nlm.nih.gov/pubmed/23330957
23.
OmarSS.HelalyHA. Prevalence of ocular findings in a sample of Egyptian patients with psoriasis. Indian J Dermatol Venereol Leprol. 2018;84(1):34-38.doi:10.4103/ijdvl.IJDVL_1239_15http://www.ncbi.nlm.nih.gov/pubmed/29067934
24.
VanaclochaF.Crespo-ErchigaV.Jiménez-PuyaRet al. Immune-Mediated inflammatory diseases and other comorbidities in patients with psoriasis: baseline characteristics of patients in the AQUILES study. Actas Dermosifiliogr. 2015;106(1):35-43.doi:10.1016/j.ad.2014.06.003http://www.ncbi.nlm.nih.gov/pubmed/25091923
25.
FotiadouC.LazaridouE. Psoriasis and uveitis: links and risks. Psoriasis. 2019;9:91-96.doi:10.2147/PTT.S179182http://www.ncbi.nlm.nih.gov/pubmed/31696050
26.
Burden-TehE.MurphyR.PsoriasisMR. Psoriasis and uveitis--should we be asking about eye symptoms?Br J Dermatol. 2014;170(3):756-757.doi:10.1111/bjd.12731http://www.ncbi.nlm.nih.gov/pubmed/24205953
KaldeckR. Ocular psoriasis; clinical review of eleven cases and some comments on treatment. AMA Arch Derm Syphilol. 1953;68(1):44-49.doi:10.1001/archderm.1953.01540070047006http://www.ncbi.nlm.nih.gov/pubmed/13057367
29.
SeeJA.WellerP. Ocular complications of PUVA therapy. Australas J Dermatol. 1993;34(1):1-4.doi:10.1111/j.1440-0960.1993.tb00834.xhttp://www.ncbi.nlm.nih.gov/pubmed/8240180
Cordero-ComaM.AnzaarF.SobrinL.FosterCS. Systemic immunomodulatory therapy in severe dry eye secondary to inflammation. Ocul Immunol Inflamm. 2007;15(2):99-104.doi:10.1080/09273940701299354http://www.ncbi.nlm.nih.gov/pubmed/17558834
32.
DemerdjievaZ.MazhdrakovaI.TsankovN. Ocular changes in patients with psoriasis. Clin Dermatol. 2019;37(6):663-667.doi:10.1016/j.clindermatol.2019.07.029http://www.ncbi.nlm.nih.gov/pubmed/31864445
33.
El-AsrarAMA.StruyfS.KangaveDet al. Cytokine profiles in aqueous humor of patients with different clinical entities of endogenous uveitis. Clin Immunol. 2011;139(2):177-184.doi:10.1016/j.clim.2011.01.014http://www.ncbi.nlm.nih.gov/pubmed/21334264
34.
OoiKG-J.GalatowiczG.CalderVL.LightmanSL. Cytokines and chemokines in uveitis: is there a correlation with clinical phenotype?Clin Med Res. 2006;4(4):294-309.doi:10.3121/cmr.4.4.294http://www.ncbi.nlm.nih.gov/pubmed/17210978
35.
RehalB.ModjtahediBS.MorseLS.SchwabIR.MaibachHI. Ocular psoriasis. J Am Acad Dermatol. 2011;65(6):1202-1212.doi:10.1016/j.jaad.2010.10.032http://www.ncbi.nlm.nih.gov/pubmed/21550135
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