TY - JOUR

T1 - Bidirectional association between atopic dermatitis, conjunctivitis, and other ocular surface diseases

T2 - A systematic review and meta-analysis

AU - Ravn, Nina H.

AU - Ahmadzay, Zohra F.

AU - Christensen, Tine A.

AU - Larsen, Henrik H.P.

AU - Loft, Nikolai

AU - Rævdal, Pernille

AU - Heegaard, Steffen

AU - Kolko, Miriam

AU - Egeberg, Alexander

AU - Silverberg, Jonathan I.

AU - Halling, Anne Sofie

AU - Thyssen, Jacob P.

N1 - Publisher Copyright: © 2020 American Academy of Dermatology, Inc.

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - atopic dermatitis

KW - blepharitis

KW - conjunctivitis

KW - eczema

KW - keratitis

KW - keratoconus

KW - meta-analysis

KW - ocular surface disease

U2 - 10.1016/j.jaad.2020.11.037

DO - 10.1016/j.jaad.2020.11.037

M3 - Review

C2 - 33253849

AN - SCOPUS:85107617629

VL - 85

SP - 453

EP - 461

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

SN - 0190-9622

IS - 2

ER -