The ocular surface · 2025
Ocular surface epithelial immune cells and corneal nerves in dry eye disease - A systematic review and meta-analysis of in vivo confocal microscopy data.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sadhu Soumen, Jalbert Isabelle, Palacios-Derflingher Luz, Alghamdi Ali, Golebiowski Blanka, Stapleton Fiona
Аннотация
PURPOSE: To examine ocular surface epithelial immune cell (EIC) density and corneal nerve parameters between patients with dry eye disease (DED) compared to healthy controls with further comparisons between auto-immune - Sjӧgren Syndrome DED (SS-DED) and non-autoimmune - non-Sjӧgren Syndrome DED (NSS-DED) subtypes.
METHODS: A systematic review and meta-analysis following PRISMA guidelines (Prospero-CRD42023446763) were conducted including studies reporting corneal and conjunctival EIC density and/or corneal nerve parameters in DED and healthy controls using in vivo confocal microscopy. Electronic databases - PubMed, Embase, Scopus, Web of Science were searched from inception to March 2025.
RESULTS: The meta-analysis included 24 studies (n = 1060 DED, n = 521 controls) reporting EIC density, 30 studies reporting nerve length (CNL; n = 1450 DED, n = 643 controls) and 20 studies reporting nerve density (CND; n = 919 DED, n = 462 controls) in the central cornea. Studies of other ocular surface locations were insufficient for meta-analysis. Higher central corneal EIC density was evident in DED compared to controls (MD: 57.9 cells/mm2; 95 % CI: 43.3, 72.5; p < 0.001), and in, SS-DED compared to NSS-DED (51.0 cells/mm2; 95 % CI: 12.0, 90.0; p = 0.01). DED had lower CNL (-4.0 mm/mm2; 95 % CI: 5.2, -2.7; p < 0.001) and CND (-7.2 nerves/mm2; 95 % CI: 10.3, -4.1; p < 0.001) compared to controls. No significant differences in nerve parameters were found between SS-DED and NSS-DED subtypes (CNL: 95 % CI: 3.0, 1.4, CND: 6.8, 4.8; p ≥ 0.46).
CONCLUSION: DED involves substantial EIC infiltration and reduced corneal nerve parameters. SS-DED is distinguished by higher EIC density than NSS-DED, while no differences were observed in corneal nerve parameters.
METHODS: A systematic review and meta-analysis following PRISMA guidelines (Prospero-CRD42023446763) were conducted including studies reporting corneal and conjunctival EIC density and/or corneal nerve parameters in DED and healthy controls using in vivo confocal microscopy. Electronic databases - PubMed, Embase, Scopus, Web of Science were searched from inception to March 2025.
RESULTS: The meta-analysis included 24 studies (n = 1060 DED, n = 521 controls) reporting EIC density, 30 studies reporting nerve length (CNL; n = 1450 DED, n = 643 controls) and 20 studies reporting nerve density (CND; n = 919 DED, n = 462 controls) in the central cornea. Studies of other ocular surface locations were insufficient for meta-analysis. Higher central corneal EIC density was evident in DED compared to controls (MD: 57.9 cells/mm2; 95 % CI: 43.3, 72.5; p < 0.001), and in, SS-DED compared to NSS-DED (51.0 cells/mm2; 95 % CI: 12.0, 90.0; p = 0.01). DED had lower CNL (-4.0 mm/mm2; 95 % CI: 5.2, -2.7; p < 0.001) and CND (-7.2 nerves/mm2; 95 % CI: 10.3, -4.1; p < 0.001) compared to controls. No significant differences in nerve parameters were found between SS-DED and NSS-DED subtypes (CNL: 95 % CI: 3.0, 1.4, CND: 6.8, 4.8; p ≥ 0.46).
CONCLUSION: DED involves substantial EIC infiltration and reduced corneal nerve parameters. SS-DED is distinguished by higher EIC density than NSS-DED, while no differences were observed in corneal nerve parameters.