Association between periodontitis and exudative retinal detachment: A population‐based cohort study

BACKGROUND: To investigate whether periodontitis, a common bacterial-induced inflammatory condition, serves as a risk factor for exudative retinal detachment (ERD), which results from fluid entering the subretinal space due to damage to the retinal pigment epithelium or leaky intraocular vessels, typically associated with inflammatory, infectious, or retinal diseases. METHODS: Using Taiwan's National Health Insurance Research Database (2000-2020), patients with periodontitis were identified based on at least three outpatient visits within 1 year. A comparison cohort without periodontitis was selected and matched 1:1 using propensity scores for sex, age, index year, and Charlson Comorbidity Index. Each group included 167,530 individuals. The periodontitis cohort was further divided into treated and untreated subgroups according to periodontal treatment codes (n = 68,705 and 98,825, respectively). RESULTS: person-years in the periodontitis and comparison groups, respectively. Patients with periodontitis were associated with a higher hazard of ERD (3.95, 3.42, and 3.56 for crude, adjusted, and adjusted subdistribution hazard ratios, respectively). Sensitivity analyses showed the increased hazard of ERD remained significant after time-lag exclusions and in two periodontitis subgroups. CONCLUSION: Based on the whole-population study in Taiwan, patients with periodontitis exhibit an increased incidence of ERD, suggesting a potential association between periodontitis and ERD. PLAIN LANGUAGE SUMMARY: Gum disease is a common infection that causes ongoing inflammation in the mouth, and growing evidence suggests it may affect more than just oral health. In this large study using national health data from Taiwan, we examined whether people with gum disease are more likely to develop exudative retinal detachment, a serious eye condition in which fluid builds up under the retina and can impair vision. By comparing 167,530 patients with gum disease with an equal number without it, matched for age, sex, and general health, we found that this eye condition occurred much more frequently among those with gum disease. Even after accounting for other medical conditions, individuals with periodontitis were more than three times as likely to experience this form of retinal detachment. This pattern was consistent regardless of whether patients had received specific gum treatments. These results suggest that chronic inflammation from gum disease may be connected to eye disorders, emphasizing that maintaining good oral health could play an important role in preserving vision and overall health.