Goals: This study aimed to evaluate the association between gastroesophageal reflux disease (GERD) and development of lacrimal drainage obstruction (LDO). Background: It has been hypothesized that GERD may contribute toward the development of LDO. Study: This was a retrospective study of Koreans aged 40 to 79 years registered in the Korean National Health Screening Cohort from 2002 to 2013. Incident cases of LDO were identified according to the Korean Classification of Disease. We compared hazard ratios (HRs) for LDO between 22,570 patients with GERD and 112,850 patients without GERD by 1:5 propensity score-matched analysis. Results: A total of 135,420 patients, representing 1,237,909 person-years, were evaluated. LDO developed in 1998 (8.9%) patients with GERD and 8565 (7.6%) patients without GERD (P<0.001). The incidence of LDO per 1000 person-years in patients with GERD was 9.7 and 8.3 in those without GERD; the age-adjusted and sex-adjusted HR was 1.17 (95% confidence interval, 1.11-1.23). This association between GERD and LDO was more pronounced among younger individuals (HR, 1.20 for patients 40 to 59-y old; HR, 1.12 for patients 60 to 79-y old) and among men (HR, 1.20 for men; HR, 1.14 for women). Patients with GERD had a higher risk of LDO than those without GERD, irrespective of history of proton-pump inhibitor use. In the sensitivity analysis, GERD patients with esophagitis had a higher risk of LDO than those without esophagitis. Conclusions: Our findings suggest that GERD is associated with an increased risk of subsequent LDO and that this effect is more pronounced among adults aged 40 to 59-years old and men.
Bibliographical noteFunding Information:
Received for publication August 10, 2017; accepted January 9, 2018. From the *Department of Ophthalmology, Severance Hospital, Insti-tute of Vision Research; †Yonsei Healthcare Big Data Based Knowledge Integration System Research Center; and ‡Institute of Convergence Science, Yonsei University College of Medicine, Seoul, Korea. T.H.R. and J.S.K. contributed equally. S.S.K. and J.S.Y. are co-corresponding authors. Supported by the Bio and Medical Technology Development Program of the National Research Foundation of Korea (NRF) funded by the Korean government, MSIP (2015M3A9E2067031), and by the Basic Science Research Program through the NRF funded by the Ministry of Science, ICT & Future Planning (NRF-2016M3A9E9941746). The authors declare that they have nothing to disclose. Address correspondence to: Sung Soo Kim, MD, PhD and Jin Sook Yoon, MD, PhD, Department of Ophthalmology, Severance Hos-pital, Institute of Vision Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-ku, Seoul 03722, Korea (e-mails: firstname.lastname@example.org; email@example.com). Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website, www.jcge.com. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MCG.0000000000001005
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