OBJECTIVE: In the present study, a systematic review and meta-analysis was conducted to investigate the association between allergic rhinitis (AR) and keratoconus.
METHODS: Relevant and eligible studies from PubMed, Web of Science, and Cochrane Library were systematically reviewed to evaluate the association between AR and keratoconus. Observational studies containing the number of patients with and without keratoconus and the number of patients with keratoconus diagnosed with or without AR were included. Two reviewers independently screened for eligible studies and extracted data from the included studies. A bivariate meta-analysis was conducted to compare the odds of keratoconus occurrence in patients with and without AR. The main outcome was the odds ratio of keratoconus occurrence in patients with AR. A sensitivity test was performed using the adjusted odds ratio reported in the included studies to validate the findings.
RESULTS: Seven studies involving 775,574 participants were included in this meta-analysis. Among them, 29,082 patients had keratoconus. The pooled odds ratio of keratoconus occurrence in patients with AR was 1.71 (95% confidence interval [CI]: 1.36-2.15; P < 0.001; I2 = 96%), and the pooled adjusted odds ratio was 1.72 (95% CI: 1.23-2.40; P = 0.001; I2 = 97%).
CONCLUSIONS: Patients with AR showed significantly higher odds of keratoconus occurrence than those without AR. Future studies are warranted to investigate the causal relationship and evaluate the cost-effectiveness of early screening using methods such as corneal topography and referral for keratoconus in patients with AR.
目的:在本研究中,我们进行了系统评价和荟萃分析,以研究过敏性鼻炎(AR)与圆锥角膜之间的关联.
方法:PubMed的相关和符合条件的研究,WebofScience,和Cochrane图书馆进行了系统评价,以评估AR和圆锥角膜之间的关系。包括观察性研究,包括有和没有圆锥角膜的患者人数以及诊断有或没有AR的圆锥角膜患者人数。两名评审员独立筛选了符合条件的研究,并从纳入的研究中提取了数据。进行了双变量荟萃分析,以比较有和没有AR的患者发生圆锥角膜的几率。主要结果是AR患者发生圆锥角膜的比值比。使用纳入研究中报告的调整后比值比进行敏感性测试,以验证结果。
结果:本荟萃分析纳入了7项研究,涉及775,574名参与者。其中,29,082名患者患有圆锥角膜。AR患者圆锥角膜发生的合并比值比为1.71(95%置信区间[CI]:1.36-2.15;P<0.001;I2=96%),合并的校正比值比为1.72(95%CI:1.23-2.40;P=0.001;I2=97%).
结论:与无AR的患者相比,有AR的患者出现圆锥角膜的几率明显更高。未来的研究有必要调查因果关系并评估使用角膜地形图和转诊圆锥角膜等方法进行早期筛查的成本效益AR患者。