Lichen Simplex Chronicus is Associated with an Increased Risk of Rhegmatogenous Retinal Detachment and Retinal Tears: A Propensity Score-Matched Cohort Study

PURPOSE: To determine whether lichen simplex chronicus (LSC) is associated with an increased risk of rhegmatogenous retinal detachment (RRD) and retinal tears without detachment (RT) compared with adults without LSC. METHODS: This retrospective propensity score-matched cohort study used TriNetX to compare adults (≥18 years) with LSC to matched adults without LSC. Patients with prior RRD, RT, ocular trauma, or proliferative diabetic retinopathy were excluded. Propensity score matching (1:1) was performed on demographics, ocular and systemic comorbidities, and prior ophthalmology encounters. Incidence of RRD, RT, the composite endpoint of RRD or RT (RRD/RT), retinopexy, RRD repair, and the composite of RRD repair or retinopexy were compared using risk analysis and Kaplan-Meier survival analysis with Cox regression, yielding risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI). RESULTS: After 1:1 propensity score matching, the study included 64,170 patients per group. LSC patients had significantly higher rates of RRD (RR 8.83, 95% CI 4.86-16.05; p<0.001), RT (RR 10.15, 95% CI 6.79-15.19; p<0.001), and composite RRD/RT (RR 9.60, 95% CI 6.78-13.60; p<0.001). On procedure analysis, retinopexy (RR 6.64, 95% CI 3.52-12.51; p<0.001), RRD repair (RR 4.07, 95% CI 2.27-7.31; p<0.001), and the composite of retinopexy or RRD repair (RR 5.08, 95% CI 3.28-7.87; p<0.001) occurred more frequently in the LSC cohort. CONCLUSION: LSC is associated with a substantially increased risk of incident diagnosis of RRD, RT, composite RRD/RT, and their procedural repair after adjustment for known risk factors. These findings suggest LSC may increase the risk of rhegmatogenous retinal pathology.