Are Periocular and Systemic Allergy Conditions Risk Factors for Pterygium?

To evaluate risk factors for pterygium and prevalence of periocular and systemic diseases among patients with pterygium. A retrospective case-control study was conducted among members of Clalit Health Services (CHS) in Israel, from 2001 to 2022. A total of 13,944 patients diagnosed with pterygium were included. For each case, three controls were matched among all CHS patients according to year of birth, sex, and ethnicity. Mixed models were used to assess differences in demographic characteristics, ocular and systemic diseases between the groups. Generalized estimating equation (GEE) logistic regression was used to estimate the odds ratios (OR) and adjust for confounders. The average age of pterygium patients was 49 ± 17 years; 51% were male. The results showed significant associations between pterygium and risk factors of vernal kerato-conjunctivitis (OR 2.52, 95% confidence interval [CI]: [1.96–3.24]), chronic allergic conjunctivitis (OR 1.98, 95% CI: [1.65–2.39]), blepharitis (OR 1.91, 95% CI: [1.78–2.04]), chalazion (OR 1.47, 95% CI: [1.30–1.67]) and unspecified systemic allergy (OR 1.21, 95% CI [1.09–1.34]), after adjusting for rural residency status. Glaucoma (OR 0.74, 95% CI [0.64–0.85]) and smoking (OR 0.70, 95% CI [0.66–0.75]) were protective factors against pterygium. Systemic and periocular inflammatory and allergic diseases are risk factors for pterygium.

本研究旨在评估翼状胬肉（pterygium）的危险因素，以及翼状胬肉患者的眼周与全身疾病患病率。本研究于2001年至2022年间，针对以色列克拉里特健康服务机构（Clalit Health Services, CHS）的参保人群开展了一项回顾性病例对照研究。本研究共纳入13944例确诊为翼状胬肉的患者；每例病例按照出生年份、性别与种族，从该机构全体参保患者中匹配3例对照个体。研究采用混合模型评估两组人群在人口学特征、眼部疾病与全身疾病方面的差异；采用广义估计方程（GEE）logistic回归计算比值比（OR）并校正混杂因素。翼状胬肉患者的平均年龄为49±17岁，其中男性占比51%。在校正农村居住状态后，研究结果显示翼状胬肉与以下危险因素存在显著关联：春季角结膜炎（vernal kerato-conjunctivitis）（OR=2.52，95%置信区间（CI）：[1.96–3.24]）、慢性变应性结膜炎（chronic allergic conjunctivitis）（OR=1.98，95%置信区间：[1.65–2.39]）、睑缘炎（blepharitis）（OR=1.91，95%置信区间：[1.78–2.04]）、霰粒肿（chalazion）（OR=1.47，95%置信区间：[1.30–1.67]）以及未特指的全身过敏反应（unspecified systemic allergy）（OR=1.21，95%置信区间：[1.09–1.34]）。青光眼（glaucoma）（OR=0.74，95%置信区间：[0.64–0.85]）与吸烟（OR=0.70，95%置信区间：[0.66–0.75]）则为翼状胬肉的保护因素。全身及眼周炎症性与变应性疾病均为翼状胬肉的危险因素。