Epidemiology Specialization Program, Universidad CES, Medellín, Colombia and Universidad del Rosario, Bogotá, Colombia.
Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
Ocul Immunol Inflamm. 2024 Dec;32(10):2388-2404. doi: 10.1080/09273948.2024.2376746. Epub 2024 Jul 29.
To synthesize the evidence and generate a combined weighted measure on the frequency of ocular manifestations of mucous membrane pemphigoid (OMMP).
Systematic literature review and meta-analysis, searching PubMed, Embase, VHL, and Google Scholar. Articles reporting patients with mucous membrane pemphigoid and ocular involvement were included. At least, two reviewers independently and in parallel participated in all the following phases; preliminary screening, full-text review, risk of bias assessment by validated tools, and data extraction. Qualitative analysis and meta-analysis were conducted. This study was previously registered in PROSPERO (CRD42023451844).
Thirty-five studies met the inclusion criteria, comprising 1,439 patients and 1,040 eyes summarized in qualitative analysis. Twenty-eight studies were included in the meta-analysis. Ages included ranged from 60.4 to 75 years. Women were reported with more frequency. The mean time for diagnosis was 55.1 months, usually with bilateral ocular disease in 90% (95% CI 78%; 96%). Trichiasis and entropion were the most frequent manifestations in up to 92%, followed by symblepharon and punctate keratitis. Ankyloblepharon, persistent epithelial defects, and visual impairment were less frequent complications. Direct immunofluorescence positivity in conjunctival biopsies was 54% (95% CI 43%; 64%). Extraocular involvement was highly frequent, being oral and skin involvement the most frequently reported.
Our systematic review and meta-analysis evidenced that patients around 60 years of age are the most affected population with a female preponderance, usually with bilateral ocular involvement. Trichiasis and entropion were the most frequent findings; although visual impairment and persistent epithelial defects were less reported, they should not be overlooked in suspected OMMP.
综合黏膜类天疱疮（OMMP）眼部表现频率的证据，并生成综合加权指标。
系统文献回顾和荟萃分析，检索 PubMed、Embase、VHL 和 Google Scholar。纳入报告黏膜类天疱疮和眼部受累患者的文章。至少有两名审查员独立平行参与所有以下阶段：初步筛选、全文审查、使用经过验证的工具评估偏倚风险和数据提取。进行定性分析和荟萃分析。本研究先前在 PROSPERO（CRD42023451844）中进行了注册。
35 项研究符合纳入标准，包括定性分析中总结的 1439 名患者和 1040 只眼睛的 28 项研究。年龄范围从 60.4 岁到 75 岁。女性发病率更高。诊断的平均时间为 55.1 个月，通常 90%（95%CI：78%；96%）的患者为双眼疾病。倒睫和睑内翻是最常见的表现，占 92%，其次是脸裂斑和点状角膜炎。永久性上皮缺损和视力障碍是较少见的并发症。结膜活检的直接免疫荧光阳性率为 54%（95%CI：43%；64%）。眼外表现高度频繁，口腔和皮肤受累最常被报道。
我们的系统回顾和荟萃分析表明，60 岁左右的患者是受影响最严重的人群，女性发病率较高，通常双眼受累。倒睫和睑内翻是最常见的表现；尽管视力障碍和永久性上皮缺损的报道较少，但在疑似 OMMP 中不应忽视。
