老龄化对干眼疾病病理生理学的影响：系统评价和荟萃分析。

Impact of aging on the pathophysiology of dry eye disease: A systematic review and meta-analysis.

机构信息

Buck Institute for Research on Aging, Novato, CA, 94945, USA; Kyoto Prefectural University of Medicine, Department of Ophthalmology, Kyoto, Japan.

Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan; Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo, Japan; Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan.

出版信息

Ocul Surf. 2022 Jul;25:108-118. doi: 10.1016/j.jtos.2022.06.004. Epub 2022 Jun 23.

DOI:10.1016/j.jtos.2022.06.004

PMID:35753664

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

The aging process greatly impacts the ocular surface microenvironment, consequently leading to DED.

摘要

目的

干眼症（DED）是一种常见的与年龄相关的眼表疾病。然而，目前尚不清楚衰老如何影响眼表微环境。本系统评价旨在研究衰老过程如何改变眼表微环境，并影响 DED 的发展。

方法

在 PubMed、EMBASE 和 Web of Science 中进行了文献检索。确定了 44 篇报告年龄相关性眼变化的研究和 14 项涉及 DED 患病率的大型流行病学研究。对其中的 14 项流行病学研究中的 8 项进行了荟萃分析。遵循系统评价和荟萃分析的首选报告项目（PRISMA）报告准则。使用随机效应模型对 1 组荟萃分析中特定研究的估计值（衰老对 DED 患病率的影响）进行了合并。

结果

荟萃分析显示，60 岁或以上老年人 DED 的患病率为 60107 例中的 5519 例（9.2%），与较年轻年龄相比，衰老的优势比为 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 T 细胞，浸润眼表上皮、泪腺和睑板腺，并伴有衰老相关的变化，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以及 Ki67 阳性细胞减少。