The association between grade of coronary heart disease and risk of developing keratopathy: a nationwide cohort study

<b>Purpose:</b> To evaluate the association between coronary heart disease (CHD) severity and the risk of developing keratopathy. <b>Method:</b> A retrospective cohort study was conducted with data from the Taiwan National Health Insurance Research Database (NHIRD). A total of 593100, 593100 and 296500 patients were included in the control, mild CHD and severe CHD groups, respectively. The primary outcomes were the development of superficial keratopathy and infectious keratitis with antibiotic usage. Cox proportional hazard regression was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the primary outcomes among the groups. <b>Results:</b> A total of 30697, 32134, and 15977 superficial keratopathy episodes and 6021, 6010, and 2982 infectious keratitis episodes were recorded in the control, mild CHD, and severe CHD groups, respectively. The incidence of superficial keratopathy was significantly greater in the severe CHD group (P = 0.037), and both groups presented a greater risk of developing superficial keratopathy than did the control group (both P < 0.05). The cumulative incidence of superficial keratopathy was also significantly greater in the severe CHD group than in the mild CHD group (P < 0.001). In the subgroup analyses, the incidence of superficial keratopathy was significantly greater in severe CHD patients than in mild CHD patients older than 70 years, and the correlation between CHD severity and superficial keratopathy incidence was significantly greater in those older than 70 years of age (P = 0.002). <b>Conclusions:</b> Severe CHD is related to a greater risk of developing superficial keratopathy, especially in those older than 70 years of age.