Impact of aging on the pathophysiology of dry eye disease: A systematic review and meta-analysis |
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| Affiliation: | 1. Buck Institute for Research on Aging, Novato, CA, 94945, USA;2. Kyoto Prefectural University of Medicine, Department of Ophthalmology, Kyoto, Japan;3. Juntendo University Graduate School of Medicine, Department of Ophthalmology, Tokyo, Japan;4. Juntendo University Graduate School of Medicine, Department of Hospital Administration, Tokyo, Japan;5. Juntendo University Graduate School of Medicine, Department of Digital Medicine, Tokyo, Japan;6. Li Ka Shing Faculty of Medicine, The University of Hong Kong (HKUMed), Department of Ophthalmology, Hong Kong, China;7. Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA;8. Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, 02114, USA;1. Rothschild Foundation Hospital, Paris, France;2. Paris University, Paris, France;1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China;2. Department of Hematology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, Guangdong, 510515, China;1. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller, School of Medicine, Miami, USA;2. Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA;3. Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA;4. Ophthalmic Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China;1. Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand;2. Optometry and Vision Sciences, College of Health and Life Sciences, Aston University, Birmingham, UK;3. Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham and Midland Eye Centre, Birmingham, UK;4. Thea Pharmaceuticals, UK |
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| Abstract: | PurposeDry 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.MethodsAn 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.ResultsMeta-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.ConclusionsThe aging process greatly impacts the ocular surface microenvironment, consequently leading to DED. |
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| Keywords: | Cellular senescence Senescent cells Inflammaging Cornea Conjunctiva Lacrimal gland Meibomian gland |
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