New Study: Patients with Periodontitis May Have a Higher Risk of Exudative Retinal Detachment

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

DentalGoodNews｜Recently, the Journal of Periodontology published a population-based cohort study from Taiwan, China: patients with periodontitis may have a higher risk of developing exudative retinal detachment (ERD). The study showed that the crude hazard ratio for ERD in the periodontitis group was 3.95, the adjusted hazard ratio was 3.42, and the adjusted subdistribution hazard ratio was 3.56.

ERD is retinal detachment caused by the accumulation of subretinal fluid, and its occurrence may be related to retinal pigment epithelium damage or intraocular vascular leakage. Based on this disease background, the study further investigated whether there is an association between periodontitis and ERD.

The study used data from the National Health Insurance Research Database of Taiwan, China (2000-2020), defining patients with periodontitis as those with at least 3 outpatient visits within 12 months. Using sex, age, index year, and Charlson Comorbidity Index (CCI) as matching factors, the study matched the control population by 1:1 propensity score, with 167,530 people in each group. The periodontitis group was further divided by periodontal treatment codes into a treated group (68,705 people) and an untreated group (98,825 people).

During follow-up, 437 people (0.26%) in the periodontitis group developed ERD, compared with 100 people (0.06%) in the control group; the incidence rates were 16.74 and 3.55 per 10⁵ person-years, respectively. The cumulative risk of ERD in the periodontitis group and both treatment subgroups was higher than that in the control group; in the sensitivity analysis excluding the time-lag factor, the elevated risk remained statistically significant.

The researchers believe that the incidence of ERD is higher in patients with periodontitis, and there may be a potential association between the two, and physicians should pay attention to periodontal health in the context of retinal disease. Regarding the mechanism, the researchers noted that the chronic inflammation of periodontitis may be related to eye diseases, but the study did not directly test this mechanism, and the relevant explanation remains speculative. In addition, the database did not include confounding factors such as psychological stress, environmental exposure, and nutritional status, and further mechanistic and clinical studies are still needed for verification.