Association between air pollutant exposure and ocular surface, anterior and middle segment and fundus eye diseases: epidemiological and mechanism evidence.

Studies show that exposure to air pollutants is linked to eye diseases, but they don't specify the impact on different eye structures. This study aims to analyse the risk of ocular surface, anterior and middle segment and fundus eye diseases among individuals exposed to common and specific air pollutants. Seven databases were searched for relevant studies published between January 2000 and August 2024. Inclusion criteria encompassed individuals of all ages, with studies providing associations between common air pollutants (carbon monoxide [CO], nitrous oxide [NO], nitrogen dioxide [NO2], sulphur dioxide [SO2], ozone [O3], black carbon, particulate matter [PM], environmental tobacco smoke [ETS]), specific air pollutants (volatile organic compounds [VOCs] in cosmetics, smoke from indoor solid fuel cookers, biomass fuel use and road dust). Pooled odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated. A total of 55 studies were included. Consistent evidence of associations was found between air pollutant exposure and eye diseases, with 51 studies reporting positive associations. The combined overall result was OR = 1.26 (95% CI, 1.20-1.32). Additionally, evidence of associations was observed for ocular surface diseases (OR = 1.29, 95% CI, 1.20-1.39), anterior and middle segment diseases (OR = 1.22, 95% CI, 1.14-1.31) and fundus oculi diseases (OR = 1.35, 95% CI, 1.17-1.57). In conclusion, the meta-analysis suggests air pollutant exposure is associated with ocular diseases, with the highest pooled risk for fundus diseases, though direct comparisons are limited by study heterogeneity.