Title : Atopy and its role in the development and progression of keratoconus: a systematic review and meta-analysis
Abstract:
Purpose:Progressive condition which is characterized by corneal thinning,distorted astigmatism and impaired vision is called keratoconus (KC). Development of a disease is often associated with genetic predisposition and environmental factors. This study seeks to investigate the relation between keratoconus and allergic eye disease,specifically allergic rhinitis (AR),eye rubbing, and atopy while exploring the influence of these factors on the progression of the disease.
Methods:Meta-analysis and comprehensive systematic review were performed to assess the associated risk factors and prevalence of keratoconus in connection with allergic diseases,eye rubbing and atopy. Relevant data was obtained from associated studies observed through PubMed,Web of Science,Scopus and Cochrane databases. Moreover,clinical records from 670 eyes belonging to 434 keratoconus(KC) patients were analyzed,with patients divided into groups regarding the presence of atopic syndromes such as allergic asthma,atopic dermatitis and allergic rhinitis.
Results:The meta-analysis identified important correlations between eye rubbing (OR = 5.22),family history of keratoconus (OR = 6.67),and allergies (OR = 2.21) with the occurrence of keratoconus. The group of patients with atopic syndrome,which involve patients with allergic rhinitis and/or asthma,demonstrated an earlier age of onset in contrast to the control group.Additionally,atopic group revealed higher corneal density in the anterior 120 μm in comparison with non-atopic keratoconus patients (P = 0.016).Regardless of no considerable changes were observed in topographical features,these results advocate that atopy and eye rubbing could contribute notably to the preliminary development and progression of keratoconus.
Conclusions:This research study validates the hypothesis that allergic disorders,especially atopic syndromes and eye rubbing, plays a key role as a risk factor in the early onset and progression of keratoconus. The outcomes emphasize the significance of managing allergic reactions and eye rubbing in order to prevent the onset and progression of keratoconus,specifically in high-risk populations. Additional research is required to analyze the underlying mechanism of these correlations and to identify potential preventive strategies.
