{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:49:04Z","timestamp":1760244544896,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The purpose of this study is to investigate the potential correlation between nasopharyngeal carcinoma (NPC) and both infectious keratitis and orbital cellulitis. The retrospective cohort study used the National Health Insurance Research Database (NHIRD) as a data source. A total number of 4184 patients with NPC diagnosis were selected and matched to 16,736 non-NPC patients via the propensity-score matching (PSM). The main outcomes are the development of infectious keratitis and orbital cellulitis according to diagnostic codes and related medications. The Cox proportional hazard regression was adopted to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of outcomes between the two groups. A total of 35 and 19 episodes of orbital cellulitis occurred in the NPC and non-NPC groups and the aHR was significantly higher in the NPC group (aHR: 1.34, 95% CI: 1.23\u20131.46, p = 0.0024). There were 2185 and 659 events of infectious keratitis in the NPC and non-NPC groups, and the NPC group revealed a significantly higher aHR than non-NPC group (aHR: 1.34, 95% CI: 1.23\u20131.46, p &lt; 0.0001). Besides, the cumulative probability of infectious keratitis was significantly higher in the NPC group than the non-NPC group (p &lt; 0.0001). The other risk factors of infectious keratitis include age from 20 to 30 years old, allergic respiratory diseases, allergic dermatological diseases, and external eye diseases (all p &lt; 0.0001). In subgroup analyses, both the incidences of infectious keratitis (aHR: 1.33, 95% CI: 1.21\u20131.47) and orbital cellulitis (aHR: 2.36, 95% CI: 1.27\u20134.39) were significantly higher than the non-NPC group. The incidence of infectious keratitis was significantly higher in NPC patients without radiotherapy (aHR: 1.40, 95% CI: 1.26\u20131.55) compared to non-NPC population, while the rate of orbital cellulitis was similar between the NPC patients without radiotherapy (aHR: 0.76, 95% CI: 0.27\u20132.14) and non-NPC population. In conclusion, the existence of NPC associates with higher incidence of infectious keratitis which increases with NPC period, and the radiotherapy may be account for the higher rate of orbital cellulitis in NPC population.<\/jats:p>","DOI":"10.3390\/cancers14235745","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T03:15:24Z","timestamp":1669173324000},"page":"5745","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Nasopharyngeal Carcinoma and Its Effect on the Infectious Eye Disease: A Nationwide Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Chia-Yi","family":"Lee","sequence":"first","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"},{"name":"Nobel Eye Institute, Taipei 100008, Taiwan"},{"name":"Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 41265, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9726-3234","authenticated-orcid":false,"given":"Ming-Ju","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Oral Cancer Research Center, Changhua Christian Hospital, Changhua 50006, Taiwan"},{"name":"Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-Yang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yih-Shiou","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan"},{"name":"Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao-Kai","family":"Chang","sequence":"additional","affiliation":[{"name":"Nobel Eye Institute, Taipei 100008, Taiwan"},{"name":"Department of Optometry, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan"},{"name":"Department of Optometry, Da-Yeh University, Chunghua 51500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1117-7878","authenticated-orcid":false,"given":"Hung-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan"},{"name":"Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Center for Tissue Engineering, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0365-7927","authenticated-orcid":false,"given":"Shun-Fa","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"},{"name":"Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/S0140-6736(15)00055-0","article-title":"Nasopharyngeal carcinoma","volume":"387","author":"Chua","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1158\/1055-9965.EPI-20-1702","article-title":"The evolving epidemiology of nasopharyngeal carcinoma","volume":"30","author":"Chang","year":"2021","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/014556130608500313","article-title":"Review of nasopharyngeal carcinoma","volume":"85","author":"Jeyakumar","year":"2006","journal-title":"Ear. Nose Throat J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101890","DOI":"10.1016\/j.ctrv.2019.101890","article-title":"Management of locally recurrent nasopharyngeal carcinoma","volume":"79","author":"Lee","year":"2019","journal-title":"Cancer Treat. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/CAD.0b013e328337160e","article-title":"Treatment approaches to nasopharyngeal carcinoma: A review","volume":"21","author":"Caponigro","year":"2010","journal-title":"Anticancer Drugs"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e30516","DOI":"10.1097\/MD.0000000000030516","article-title":"The influence of marital status on survival in patients with nasopharyngeal carcinoma: A surveillance, epidemiology, and end results database analysis","volume":"101","author":"Yu","year":"2022","journal-title":"Medicine"},{"key":"ref_8","first-page":"3687","article-title":"Nasopharyngeal carcinoma: A review of current updates","volume":"15","author":"Wu","year":"2018","journal-title":"Exp. Ther. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"10732748211050587","DOI":"10.1177\/10732748211050587","article-title":"Epidemiological Profile and clinicopathological, therapeutic, and prognostic characteristics of nasopharyngeal carcinoma in northern Morocco","volume":"28","author":"Reffai","year":"2021","journal-title":"Cancer Control"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1002\/lary.24435","article-title":"Association of rhinosinusitis with nasopharyngeal carcinoma: A population-based study","volume":"124","author":"Hung","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/lary.27303","article-title":"Irradiated ears in nasopharyngeal carcinoma survivors: A review","volume":"129","author":"Young","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/01.mlg.0000248738.55387.44","article-title":"Early swallowing problems in a cohort of patients with nasopharyngeal carcinoma: Symptomatology and videofluoroscopic findings","volume":"117","author":"Ku","year":"2007","journal-title":"Laryngoscope"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"417","DOI":"10.2500\/ajra.2009.23.3336","article-title":"Central nervous system infection in patients with postirradiated nasopharyngeal carcinoma: A case-controlled study","volume":"23","author":"Liang","year":"2009","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1038\/sj.eye.6701358","article-title":"Nasopharyngeal carcinoma with orbital invasion","volume":"18","author":"Hsu","year":"2004","journal-title":"Eye"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1080\/01676830.2017.1279658","article-title":"Ophthalmic involvement in nasopharyngeal carcinoma","volume":"36","author":"Wong","year":"2017","journal-title":"Orbit"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3857\/roj.2020.00213","article-title":"Late side effects of radiation treatment for head and neck cancer","volume":"38","author":"Brook","year":"2020","journal-title":"Radiat. Oncol. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1177\/0194599816629436","article-title":"Sinonasal tract inflammation as a precursor to nasopharyngeal carcinoma: A systematic review and meta-analysis","volume":"154","author":"Riley","year":"2016","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_18","first-page":"92","article-title":"Quantitative assessment of the association between interleukin-10 promoter gene polymorphisms and nasopharyngeal carcinoma susceptibility","volume":"107","author":"Huang","year":"2016","journal-title":"Minerva Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/IOP.0b013e318171a629","article-title":"Nasopharyngeal carcinoma with orbital involvement","volume":"24","author":"Lee","year":"2008","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/1120672118757430","article-title":"Surgery option in the management of delayed diplopia after radiation therapy for nasopharyngeal carcinoma","volume":"28","author":"Zou","year":"2018","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_21","first-page":"e13735","article-title":"Corticosteroid therapy in optic neuropathy secondary to nasopharyngeal carcinoma","volume":"13","author":"Wahab","year":"2021","journal-title":"Cureus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.survophthal.2017.12.001","article-title":"Orbital cellulitis","volume":"63","author":"Tsirouki","year":"2018","journal-title":"Surv. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"216","DOI":"10.12968\/hmed.2016.77.4.216","article-title":"Assessment and management of orbital cellulitis","volume":"77","author":"Amin","year":"2016","journal-title":"Br. J. Hosp. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1016\/j.ophtha.2017.05.012","article-title":"Update on the Management of Infectious Keratitis","volume":"124","author":"Austin","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.micpath.2016.12.013","article-title":"Pathogenesis of microbial keratitis","volume":"104","author":"Lakhundi","year":"2017","journal-title":"Microb. Pathog."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1038\/s41433-020-01339-3","article-title":"Infectious keratitis: An update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance","volume":"35","author":"Ting","year":"2021","journal-title":"Eye"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1007\/s10096-020-03985-7","article-title":"Moraxella keratitis: Epidemiology and outcomes","volume":"39","author":"Hoarau","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/IOP.0000000000001361","article-title":"Microbial keratitis in thyroid eye disease: Clinical features, microbiological profile, and treatment outcome","volume":"35","author":"Naik","year":"2019","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ajo.2021.03.013","article-title":"The risks of corneal surface damage in aqueous-deficient dry eye disease: A 17-year population-based study in Taiwan","volume":"227","author":"Hung","year":"2021","journal-title":"Am. J. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1080\/09273948.2016.1276933","article-title":"Keratitis in dry eye disease and topical ciclosporin A","volume":"25","author":"Leonardi","year":"2017","journal-title":"Ocul. Immunol. Inflamm."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1002\/lary.28254","article-title":"Risk of ocular complications following radiation therapy in patients with nasopharyngeal carcinoma","volume":"130","author":"Lin","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.bjorl.2015.04.006","article-title":"Orbital metastasis as the primary presentation of nasopharyngeal carcinoma","volume":"82","author":"Shin","year":"2016","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ijporl.2018.05.006","article-title":"Management of pediatric orbital cellulitis: A systematic review","volume":"110","author":"Wong","year":"2018","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1136\/bjophthalmol-2014-305222","article-title":"Orbital cellulitis in Scotland: Current incidence, aetiology, management and outcomes","volume":"98","author":"Murphy","year":"2014","journal-title":"Br. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1080\/08164622.2021.1878824","article-title":"Microbial keratitis in a tertiary centre in Queensland, Australia (1999\u20132015)","volume":"104","author":"Green","year":"2021","journal-title":"Clin. Exp. Optom."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"407","DOI":"10.3341\/kjo.2022.0064","article-title":"Infectious keratitis in patients with ocular Sj\u00f6gren\u2019s syndrome","volume":"36","author":"Kim","year":"2022","journal-title":"Korean J. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.4269\/ajtmh.16-0453","article-title":"Recurrent fungal keratitis and blepharitis caused by aspergillus flavus","volume":"95","author":"Lee","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2719","DOI":"10.1002\/lary.29702","article-title":"Socioeconomic status and survival in nasopharyngeal carcinoma: A population-based study","volume":"131","author":"McCoul","year":"2021","journal-title":"Laryngoscope"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/5745\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:24:45Z","timestamp":1760145885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/23\/5745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,23]]},"references-count":38,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14235745"],"URL":"https:\/\/doi.org\/10.3390\/cancers14235745","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2022,11,23]]}}}