{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:19:27Z","timestamp":1764890367005,"version":"3.46.0"},"reference-count":18,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Taiwan Ministry of Health and Welfare Clinical Trial Center","award":["MOHW113-TDU-B-212-114009"],"award-info":[{"award-number":["MOHW113-TDU-B-212-114009"]}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-111-105","DMR-112-087","DMR-113-009","DMR-113-156"],"award-info":[{"award-number":["DMR-111-105","DMR-112-087","DMR-113-009","DMR-113-156"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate whether systemic lupus erythematosus (SLE) increases the risk of cataract development and to evaluate the impact of corticosteroid use and dosage on this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationwide retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Using Taiwan\u2019s National Health Insurance (NHI) database, which covers over 99.9% of the population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The SLE cohort included 30\u2009501 newly diagnosed adults from 2011 to 2020. For each patient with SLE, four individuals without SLE were selected from the NHI database using frequency matching by age (in 5\u2009year intervals), gender and index year of diagnosis, resulting in a comparison cohort of 122\u2009004 individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was incident cataract. Secondary outcomes included risk stratification by age, sex, comorbidities and corticosteroid dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SLE patients had a higher incidence of cataracts than non-SLE individuals (adjusted HR (aHR) = 1.73, 95%\u2009CI 1.66 to 1.81). Stratified analyses showed elevated risks in women (aHR=1.74, 95%\u2009CI 1.66 to 1.83), men (aHR=1.68, 95%\u2009CI 1.52 to 1.86), and across age groups 20\u201349 years (aHR=2.32, 95%\u2009CI 2.11 to 2.56), 50\u201364 years (aHR=1.60, 95%\u2009CI 1.51 to 1.69), and \u226565 years (aHR=1.50, 95%\u2009CI 1.36 to 1.66). Analysis of corticosteroid exposure revealed that cumulative dose showed a trend towards increased risk at high exposure (adjusted OR (aOR) = 1.14, 95%\u2009CI 0.99 to 1.31), while average daily dose demonstrated a dose\u2013response effect: 1\u20135\u2009mg\/day (aOR=1.31, 95%\u2009CI 1.13 to 1.52) and \u22655\u2009mg\/day (OR=2.48, 95%\u2009CI 2.16 to 2.86).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adults with SLE have an increased risk of developing cataracts compared with matched controls, and higher average daily corticosteroid doses are associated with this risk. These findings highlight the need for careful monitoring of ocular complications in SLE patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101079","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T02:10:12Z","timestamp":1761617412000},"page":"e101079","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of cataract in patients with systemic lupus erythematosus: a retrospective cohort study in Taiwan"],"prefix":"10.1136","volume":"15","author":[{"given":"De-Yi","family":"Liu","sequence":"first","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Tso","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiu-Ming","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting-An","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-An","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Chen","family":"Su","sequence":"additional","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei-Ti","family":"Yao","sequence":"additional","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-1068","authenticated-orcid":false,"given":"Te-Chun","family":"Shen","sequence":"additional","affiliation":[{"name":"School of Medicine, China Medical University, Taichung, Taiwan"},{"name":"Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan"},{"name":"Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heng-Jun","family":"Lin","sequence":"additional","affiliation":[{"name":"Management Office for Health Data, China Medical College Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuu-Jen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Management Office for Health Data, China Medical College Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"2025120415083156000_15.10.e101079.1","doi-asserted-by":"publisher","DOI":"10.7326\/AITC202006020"},{"key":"2025120415083156000_15.10.e101079.2","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/4uc7e8"},{"key":"2025120415083156000_15.10.e101079.3","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2017.1327352"},{"key":"2025120415083156000_15.10.e101079.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-017-0479-9"},{"key":"2025120415083156000_15.10.e101079.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30544-5"},{"key":"2025120415083156000_15.10.e101079.6","doi-asserted-by":"publisher","DOI":"10.1097\/icu.0000000000000340"},{"key":"2025120415083156000_15.10.e101079.7","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.13892"},{"key":"2025120415083156000_15.10.e101079.8","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s10792-021-02058-8","article-title":"Natural and iatrogenic ocular manifestations of rheumatoid arthritis: a systematic review","volume":"42","author":"Dammacco","year":"2022","journal-title":"Int Ophthalmol"},{"key":"2025120415083156000_15.10.e101079.9","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s00296-014-3129-5","article-title":"Risk factors for cataracts in systemic lupus erythematosus (SLE)","volume":"35","author":"Alderaan","year":"2015","journal-title":"Rheumatol Int"},{"key":"2025120415083156000_15.10.e101079.10","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1080\/09273948.2018.1501495","article-title":"Ocular Involvement in Systemic Lupus Erythematosus: The Experience of Two Tertiary Referral Centers","volume":"26","author":"Dammacco","year":"2018","journal-title":"Ocul Immunol Inflamm"},{"key":"2025120415083156000_15.10.e101079.11","first-page":"283","article-title":"Ocular involvement in systemic lupus erythematosus patients: a paradigm shift based on the experience of a tertiary referral center","volume":"29","author":"Dias-Santos","year":"2020","journal-title":"Lupus (Los Angel)"},{"key":"2025120415083156000_15.10.e101079.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12886-020-01360-w","article-title":"Risks of ophthalmic disorders in patients with systemic lupus erythematosus - a secondary cohort analysis of population-based claims data","volume":"20","author":"Hsu","year":"2020","journal-title":"BMC Ophthalmol"},{"key":"2025120415083156000_15.10.e101079.13","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4103\/jwas.jwas_59_22","article-title":"Prevalence and Spectrum of Eye Disorders Among Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus in a Tertiary Hospital in Northern Nigeria","volume":"12","author":"Abdullahi","year":"2022","journal-title":"J West Afr Coll Surg"},{"key":"2025120415083156000_15.10.e101079.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2015.08.007"},{"key":"2025120415083156000_15.10.e101079.15","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2013.147"},{"key":"2025120415083156000_15.10.e101079.16","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1001\/jamainternmed.2015.3540","article-title":"Nationwide Population Science: Lessons From the Taiwan National Health Insurance Research Database","volume":"175","author":"Hsing","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2025120415083156000_15.10.e101079.17","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1164\/rccm.201310-1792LE","article-title":"Increased risk of asthma in patients with systemic lupus erythematosus","volume":"189","author":"Shen","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"2025120415083156000_15.10.e101079.18","doi-asserted-by":"crossref","first-page":"721119","DOI":"10.3389\/fmed.2022.721119","article-title":"Periodontitis and Subsequent Risk of Cataract: Results From Real-World Practice","volume":"9","author":"Yeh","year":"2022","journal-title":"Front Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-101079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:14:56Z","timestamp":1764890096000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-101079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":18,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,27]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bmjopen-2025-101079"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-101079","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}