Taiwan Cohort Links Psoriasis to 32% Higher Cataract Risk, Modulated by Phototherapy and Systemic Therapy

The study followed patients from Taiwan's National Health Insurance database, using a nested case-control design to examine treatment effects among those who developed cataracts. Psoriasis involves chronic systemic inflammation that can accelerate lens opacification through oxidative stress and cytokine pathways, an association observed consistently across age, sex, and psoriatic arthritis subgroups. Phototherapy with PUVA raised cataract odds (aOR 1.88) while biologics and JAK inhibitors lowered them (aOR 0.49), suggesting treatment choice directly influences ocular outcomes beyond disease severity alone.

Prior observational data from the Nurses' Health Study and UK Biobank cohorts have shown elevated cataract incidence in autoimmune conditions, yet psoriasis-specific eye risks remain underemphasized in dermatology guidelines compared to cardiovascular screening. This analysis highlights how UV-based therapies add iatrogenic burden while targeted immunomodulators may confer protection, a pattern missed in smaller single-center reports. Public health impact is notable given psoriasis prevalence near 3% in many populations and rising cataract surgery rates with aging.

Next steps require prospective cohorts tracking cumulative UV dose against cataract incidence and randomized trials comparing ocular endpoints across therapy classes to guide screening intervals for high-risk patients.