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Mejía-Salgado G, Muñoz-Vargas PT, Cifuentes-González C, Flórez-Esparza G, Paquentín-Jiménez R, Castro-Monreal MÁ, Medina-Galindo N, Hernández-Herrera GN, Concha-del-Río LE, de-la-Torre A. Quantitative changes in the corneal endothelium and central corneal thickness during anterior chamber inflammation: A systematic review and meta-analysis. PLoS One 2024; 19:e0296784. [PMID: 38181008 PMCID: PMC10769021 DOI: 10.1371/journal.pone.0296784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/19/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE To establish the effects of anterior chamber inflammation (ACI) on the corneal endothelium parameters and central corneal thickness (CCT). METHODS We conducted a comprehensive literature review using medical databases (PubMed, EMBASE, VHL, and medRxiv) on March 8, 2023, for studies that included patients with ACI who had undergone specular microscopy or pachymetry. Case series with >10 patients, cross-sectional, case-control, and cohort studies were included. The risk of bias was assessed using CLARITY tools and validated scales such as those by Hassan Murad et al. and Hoy et al. A narrative synthesis and a quantitative standardized mean difference meta-analysis, I2 heterogeneity assessment, and publication bias tests were conducted. The study was registered in PROSPERO (CRD42023420148) and approved by the Universidad del Rosario ethical committee (DVO005 2277- CV1712). RESULTS Thirty-four studies, encompassing 1,388 eyes with ACI, were included. Compared with healthy controls, overall, ACI eyes show significant mean differences in endothelial parameters (endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX)) (P < 0.05). In the subgroup analysis compared with healthy controls, both active and chronic-recurrent ACI demonstrated a reduced ECD. An increased CV was observed in active, inactive, and chronic-recurrent ACI. Lower HEX was evident in inactive, acute, and chronic-recurrent ACI, while both active and acute ACI exhibited high CCT. CONCLUSION ACI leads to significant alterations in endothelial parameters and CCT. The primary contributors to these changes are increased IOP, uveitis duration, and intraocular surgeries. Further studies are needed to explore the impact of ACI etiology on the endothelium, potential biases in IOP measurements during acute ACI episodes, and the potential necessity for monitoring the endothelial parameters and CCT in patients with chronic ACI.
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Affiliation(s)
- Germán Mejía-Salgado
- Institute of Translational Medicine (IMT), Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Institute of Translational Medicine (IMT), Ophthalmology Interest Group, Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Paula Tatiana Muñoz-Vargas
- Postgraduate Master’s Program in Epidemiology Universidad CES, Medellín, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
| | - Carlos Cifuentes-González
- Institute of Translational Medicine (IMT), Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Postgraduate Master’s Program in Epidemiology Universidad CES, Medellín, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
| | - Gabriela Flórez-Esparza
- Institute of Translational Medicine (IMT), Ophthalmology Interest Group, Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Rebeca Paquentín-Jiménez
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Miguel Ángel Castro-Monreal
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Naomi Medina-Galindo
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Gilma Norella Hernández-Herrera
- Postgraduate Master’s Program in Epidemiology Universidad CES, Medellín, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
| | - Luz Elena Concha-del-Río
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Alejandra de-la-Torre
- Institute of Translational Medicine (IMT), Ophthalmology Interest Group, Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
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