Prevalence, Types, and Steroid-Associated Risk Factors of Cataracts in Patients with Common Rheumatic Diseases: A Cross-Sectional, Hospital-Based Study in Rajshahi, Bangladesh

Background: Cataracts, a leading cause of global blindness, can develop in association with various rheumatic diseases, which primarily impact joints, bones, serosa, and tissues, including the eyes. The use of steroids in rheumatic diseases contributes to the emergence of posterior subcapsular cataracts. However, current research in this field is limited and necessitates further exploration.

Objectives: This study aimed to determine the prevalence and types of cataracts in patients with common rheumatic diseases and to investigate the association between the duration of steroid use and the development of cataracts.

Materials and Methods: A cross-sectional, hospital-based study was conducted in Rajshahi, Bangladesh, including 112 patients with common rheumatic diseases. Comprehensive information about each patient's health history, medications, and eye examinations was collected. Cataract types and grading were classified according to the Lens Opacities Classification System 3. Statistical analyses were performed to evaluate the association between rheumatic disease types, cataract development, and steroid use.

Results: The study included a total of 112 patients with common rheumatic diseases, out of which 65.2% (73) were females and 34.8% (39) were males. Patients in the age group of 40-59 years accounted for the largest segment, making up 52.7% (59) of the total participants. The overall prevalence of cataracts in the study population was 38.4% (43 out of 112 patients). Gender-wise, the prevalence of cataracts was found to be significantly higher in females (58.1%; 25 out of 43 cataract patients) compared to males (41.9%; 18 out of 43 cataract patients). Age-wise, the prevalence of cataracts was markedly higher in the 40-59 years age group, accounting for 69.8% (30 out of 43 cataract patients) of all cataract cases. With regards to cataract type, posterior subcapsular cataracts emerged as the most common variant, accounting for 60.5% (26 out of 43) of all cataract cases. In terms of disease association, a strong correlation was observed between the duration of steroid use and the development of cataracts. Patients who had been using steroids for more than five years showed a cataract prevalence of 72.1% (31 out of 43). Statistical analyses affirmed a significant association between prolonged steroid use and cataract formation (p<0.05).

Conclusions: Our study underscores the importance of regular ophthalmic examinations and interdisciplinary collaboration between rheumatologists and ophthalmologists in managing ocular health in patients with rheumatic diseases, especially those undergoing long-term steroid therapy. Further research is needed to better understand the underlying mechanisms of ocular involvement in rheumatic diseases and explore novel therapeutic approaches.