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Journal of the American Academy of Dermatology

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Bidirectional association between atopic dermatitis, conjunctivitis, and other ocular surface diseases: A systematic review and meta-analysis - 08/07/21

Doi : 10.1016/j.jaad.2020.11.037 
Nina H. Ravn, MD a, b, Zohra F. Ahmadzay, MD a, Tine A. Christensen, MD a, Henrik H.P. Larsen, MS a, b, Nikolai Loft, MD a, b, Pernille Rævdal, MD c, d, Steffen Heegaard, MD, DMSci d, e, Miriam Kolko, MD, PhD c, d, Alexander Egeberg, MD, PhD a, b, Jonathan I. Silverberg, MD, PhD, MPH f, Anne-Sofie Halling, MD a, b, Jacob P. Thyssen, MD, PhD, DMSci g, ⁎
a Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark 
b Copenhagen Research Group for Inflammatory Skin, Hellerup, Denmark 
c Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark 
d Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark 
e Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 
f Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC 
g Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark 

∗Reprint requests: Jacob P. Thyssen, MD, PhD, DMSci, Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark.Department of Dermatology and AllergyHerlev and Gentofte HospitalUniversity of CopenhagenGentofte Hospitalsvej 15Hellerup2900Denmark

Abstract

Background

Conjunctivitis and several other ocular surface diseases (OSDs) have been linked to atopic dermatitis (AD) and its treatment.

Objectives

To examine the association between AD, conjunctivitis, and other OSDs.

Methods

A systematic review and meta-analysis was performed. Two authors independently searched EMBASE, PubMed, SCOPUS, and Web of Science and performed title/abstract and full-text review and data abstraction. Pooled random-effects prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.

Results

The search yielded 5719 nonduplicate articles; 134 were included in the quantitative analysis. AD was associated with conjunctivitis compared to reference individuals (OR, 2.78; 95% CI, 2.33-3.32); the prevalences of conjunctivitis in patients with AD and reference individuals were 31.7% (95% CI, 27.7-35.9) and 13.3% (95% CI, 11.0-15.7), respectively. Keratoconus (OR, 3.71; 95% CI, 1.99-6.94) and ocular herpes simplex (OR, 3.65; 95% CI 2.04-6.51) were also associated with AD.

Limitations

Disease definitions differed and often relied on self-reports. Few studies provided data concerning AD phenotype or OSDs other than conjunctivitis.

Conclusions

Conjunctivitis is the most common ocular comorbidity in AD. Signs and symptoms of conjunctivitis and other OSDs in AD may be underreported, making proactive inquiry and examination by physicians treating patients with AD important.

Il testo completo di questo articolo è disponibile in PDF.

Key words : atopic dermatitis, blepharitis, conjunctivitis, eczema, keratitis, keratoconus, meta-analysis, ocular surface disease

Abbreviations used : AD, CI, IL, IL-4Rα, OR, OSD, PRISMA, SCORAD


Mappa


 Drs Ravn and Ahmadzay are cofirst authors.
 Funding sources: Drs Thyssen and Halling are supported by an unrestricted grant from the Lundbeck Foundation.
 IRB approval status: Not applicable.


© 2020  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 85 - N° 2

P. 453-461 - agosto 2021 Ritorno al numero
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