SLE Patients Face 73 Percent Higher Risk of Cataracts, With Early Onset Seen in Young Adults: Study Finds
Taiwan: A new population-based cohort study from Taiwan has found that adults diagnosed with systemic lupus erythematosus (SLE) face a significantly higher risk of developing cataracts compared with individuals without the autoimmune disease.
The research, published in BMJ Open by Dr. De-Yi Liu from the School of Medicine, China Medical University, Taichung, Taiwan, and colleagues, also highlighted the role of corticosteroid therapy in amplifying this risk.
The study, which utilized Taiwan’s National Health Insurance (NHI) database covering over 99.9% of the population, included 30,501 adults newly diagnosed with SLE between 2011 and 2020. Each patient was compared with four age-, sex-, and year-matched controls without SLE, resulting in a total of 122,004 participants in the comparison group. The researchers tracked the incidence of cataracts as the primary outcome and assessed how age, gender, comorbidities, and corticosteroid use influenced this risk.
The study revealed the following notable findings:
- Adults with systemic lupus erythematosus (SLE) had a 73% higher likelihood of developing cataracts compared with those without SLE (adjusted hazard ratio [aHR]: 1.73).
- The risk was slightly higher among women (aHR: 1.74) than men (aHR: 1.68).
- Younger adults aged 20–49 years exhibited the highest risk, with an aHR of 2.32, indicating that cataracts tend to appear earlier in SLE patients than in the general population.
- Corticosteroid therapy, commonly used in SLE management, significantly contributed to cataract risk.
- A clear dose–response pattern was observed — patients taking 1–5 mg/day of corticosteroids had an adjusted odds ratio (aOR) of 1.31, while those on ≥5 mg/day showed a markedly higher risk (aOR: 2.48).
- Cumulative corticosteroid exposure showed a modest but statistically nonsignificant trend toward increased cataract risk (aOR: 1.14).
The authors emphasized that these findings highlight the importance of regular ophthalmic screening and cautious corticosteroid management among patients with SLE. Given that cataract formation can significantly affect quality of life and visual function, proactive monitoring may help in early detection and timely intervention.
The researchers acknowledged certain limitations—particularly the lack of data on disease activity, laboratory results, and lifestyle factors, which may influence cataract development.
The study reinforces that adults with systemic lupus erythematosus are at significantly elevated risk for cataract formation, especially when receiving higher doses of corticosteroids.
"The findings highlight the need for careful eye health monitoring and judicious use of corticosteroid therapy in clinical practice. Further research is warranted to explore how disease activity and long-term treatment patterns affect ocular complications in this patient population," the authors concluded.
Reference:
Liu D, Chung C, Wang Y, et alRisk of cataract in patients with systemic lupus erythematosus: a retrospective cohort study in TaiwanBMJ Open 2025;15:e101079. doi: 10.1136/bmjopen-2025-101079
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