The Bidirectional Association between Psoriatic Disease and Uveitis: An Updated Meta-Analysis

Background: In the past decade, there has been growing research interest in the association between psoriatic diseases and uveitis due to the potential pathogenetic links. However, observational studies have reported inconsistent results. Methods: We thoroughly searched PubMed, Embase, and Web of Science for cohort or case-control studies investigating the bidirectional association between psoriatic diseases (psoriasis and psoriatic arthritis) and uveitis. The Newcastle-Ottawa Quality Assessment Scale was used for quality evaluation of included studies. Egger’s test was used for publication bias assessment. We employed a random-effects model to pool individual data, using odds ratios (ORs) with 95% confidence interval (CI) as the effect measure. Results: Eleven cohort studies and 1 case-control study with 9,641,856 participants were included. Eleven studies were considered as good quality, and 1 study was considered as fair quality. Egger’s test indicated no significant publication bias. The meta-analysis indicated that patients with psoriatic disease was at higher risk of developing uveitis (OR: 2.14, 95% CI: 1.57-2.90). The result maintained consistent in patients with psoriatic arthritis (OR: 3.13, 95% CI: 2.10-4.67) but not in those with psoriasis without arthritis (OR: 1.40, 95% CI: 0.91-2.14). We also found that uveitis was associated with an increased risk of psoriatic disease (OR: 2.56, 95% CI: 1.66-3.96) including psoriasis without arthritis (OR: 1.99, 95% CI: 1.12-3.53) and psoriatic arthritis (OR: 3.53, 95% CI: 2.08-5.99). Conclusion: Our study suggested that uveitis was more likely to be bidirectionally associated with psoriatic arthritis rather than psoriasis without arthritis. More investigations focusing on the mechanisms are needed to better understand these findings from observational studies.