干眼症(DED)是一种常见的年龄相关性眼表疾病。然而,目前尚不清楚衰老如何影响眼表微环境。本系统综述旨在研究衰老过程如何改变眼表微环境并影响DED的发展。
在PubMed中进行了文章搜索,EMBASE,和WebofScience。确定了44项报告与年龄相关的眼部变化的研究和14项涉及DED患病率的大型流行病学研究。对14项流行病学研究中的8项进行了荟萃分析。遵循系统审查和荟萃分析(PRISMA)报告指南的首选报告项目。在随机效应模型中使用一组荟萃分析将特定研究的估计值(衰老对DED患病率的影响)组合起来。
荟萃分析显示,60岁或以上的老年人DED患病率为60107人中的5519人(9.2%),与年轻年龄相比的衰老比值比为1.313(95%置信区间[CI];1.107,1.557)。随着年龄的增长,眼表完整性和泪膜稳定性下降。各种炎症细胞,包括衰老相关的T细胞,浸润眼表上皮,泪腺,和睑板腺,伴随着衰老相关的变化,包括8-OHdG和脂褐素样内含物的积累,p53和凋亡相关基因的表达增加,Ki67阳性细胞减少。
老化过程极大地影响了眼表微环境,从而导致DED。
Dry eye disease (DED) is a common age-related ocular surface disease. However, it is unknown how aging influences the ocular surface microenvironment. This systematic
review aims to investigate how the aging process changes the ocular surface microenvironment and impacts the development of DED.
An article search was performed in PubMed, EMBASE, and Web of Science. 44 studies reporting on age-related ocular changes and 14 large epidemiological studies involving the prevalence of DED were identified. 8 out of 14 epidemiological studies were further analyzed with meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. Study-specific estimates (impact of aging on the prevalence of DED) were combined using one-group meta-analysis in a random-effects model.
Meta-analysis revealed the prevalence of DED in the elderly aged 60 years old or older was 5519 of 60107 (9.2%) and the odds ratio of aging compared to younger age was 1.313 (95% confidence interval [CI]; 1.107, 1.557). With increasing age, the integrity of the ocular surface and tear film stability decreased. Various inflammatory cells, including senescent-associated T-cells, infiltrated the ocular surface epithelium, lacrimal gland, and meibomian gland, accompanied by senescence-related changes, including accumulation of 8-OHdG and lipofuscin-like inclusions, increased expression of p53 and apoptosis-related genes, and decreased Ki67 positive cells.
The aging process greatly impacts the ocular surface microenvironment, consequently leading to DED.