Iqbal Sana, Ramini Abhishek, Kaja Simon
Program in Molecular Pharmacology and Therapeutics, Loyola University Chicago, Maywood, IL, USA.
Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
Ocul Surf. 2025 Jan;35:100-116. doi: 10.1016/j.jtos.2024.12.003. Epub 2024 Dec 12.
Exposure to particulate matter (PM) and air pollution has been implicated in the etiology of ocular surface diseases (OSD). The purpose of this systematic review is to evaluate and synthesize peer-reviewed literature on the impact of PM exposure on the ocular surface, integrating results from preclinical in vitro and in vivo studies with clinical findings to provide a comprehensive understanding of molecular mechanisms, physiological effects, clinical implications, and potential therapies to target acute and chronic PM-induced ocular toxicity.
A systematic literature search was performed using PubMed and EMBASE over the period from 2009 to 2024 following the recommendations for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. 102 studies were identified that met the inclusion/exclusion criteria. All studies were assessed for the risk of bias and qualitative data were analyzed.
Preclinical studies using models of corneal and conjunctival cells found that exposure to PM and similar air pollutants resulted in apoptosis, primarily via inflammatory and oxidative stress pathways as well as allergic and immune responses. Animal models resulted in phenotypes reminiscent of that of dry eye disease, presenting with reduced tear volumes and ocular surface damage. These results were corroborated by clinical studies, which reported that patients commonly presented with symptoms of itching, burning, and irritation, and ocular surface signs correlated with a diagnosis of dry eye disease, conjunctivitis, and allergic eye disease.
This systematic review provides a comprehensive summary of our current understanding of PM exposure on the ocular surface, highlighting the correlation between exposure to PM and ocular surface dysfunction.
接触颗粒物（PM）和空气污染与眼表疾病（OSD）的病因有关。本系统评价的目的是评估和综合同行评审的关于PM暴露对眼表影响的文献，整合临床前体外和体内研究结果与临床发现，以全面了解分子机制、生理效应、临床意义以及针对急性和慢性PM诱导的眼毒性的潜在治疗方法。
按照系统评价和Meta分析的首选报告项目（PRISMA）报告指南的建议，于2009年至2024年期间使用PubMed和EMBASE进行了系统的文献检索。确定了102项符合纳入/排除标准的研究。对所有研究进行偏倚风险评估并分析定性数据。
使用角膜和结膜细胞模型的临床前研究发现，接触PM和类似空气污染物会导致细胞凋亡，主要通过炎症和氧化应激途径以及过敏和免疫反应。动物模型呈现出类似于干眼病的表型，表现为泪液量减少和眼表损伤。临床研究证实了这些结果，临床研究报告称患者通常表现出瘙痒、灼烧和刺激症状，眼表体征与干眼病、结膜炎和过敏性眼病的诊断相关。
本系统评价全面总结了我们目前对PM暴露对眼表影响的理解，突出了PM暴露与眼表功能障碍之间的相关性。
