Objective:

To assess the association between biologic therapy and the risk of ocular surface diseases in psoriasis patients compared to nonbiologic systemic therapy.

Approach:

Key Findings:

• Biologic therapy was associated with a lower risk of dry eye disease, keratitis, and conjunctivitis.
• Lower-risk associations were evident by 6 months and persisted for up to 10 years.
• Biologic therapy also showed lower risk for external eye diseases like blepharitis and variable reductions in glaucoma and age-related cataract.
• No consistent reduction in retinal or vitreous diseases was found, though some regional analyses indicated lower risk for age-related macular degeneration.

Interpretation:

The findings suggest that biologic therapy in psoriasis may reduce the risk of ocular surface diseases, which could influence treatment decisions and interdisciplinary management.

Limitations:

• The study is observational and cannot establish causation.
• Potential misclassification from ICD-10 coding.
• Possible residual confounding related to psoriasis severity and treatment adherence.
• Heterogeneity within broad diagnostic categories like keratitis.
• Separate matching for each follow-up interval may introduce selection and survival bias.

Conclusion:

Biologic therapy in psoriasis is associated with a lower risk of ocular surface disease, warranting consideration of ocular outcomes in treatment decisions.

Sources:

• Eye
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