Atopic triad (allergic rhinitis, eczema, and asthma) and eye rubbing as risk factors for keratoconus: a systematic review and meta-analysis

Abdulmajeed Albalawi; Alanoud Alharbi; Hussain Alhasani; Amal Alharbi; Raghad Abdullah; Abrar Alamrani; Amal Althobaiti; Ziad Albalwi; Yassmeen Alblowi; Nuwayr Albalawi; Nujud Albalawi; Atheer Alhwaiti; Turki Fehaid Algethami; Dina Abusabir; Abeer Kalbouneh

doi:10.18203/2394-6040.ijcmph20211393

Authors

Abdulmajeed Albalawi Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Alanoud Alharbi Department of Family Medicine, King Fahad Specialist Hospital, Buraydah, Qassim, Saudi Arabia
Hussain Alhasani College of Medicine, Umm Al Qura University, Al-Qunfudah, Saudi Arabia
Amal Alharbi Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Raghad Abdullah The program of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
Abrar Alamrani Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Amal Althobaiti Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Ziad Albalwi Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Yassmeen Alblowi Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Nuwayr Albalawi Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Nujud Albalawi Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Atheer Alhwaiti Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Turki Fehaid Algethami College of Medicine, Taibah University, Medina, Saudi Arabia
Dina Abusabir Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
Abeer Kalbouneh Faculty of Medicine, Gezira University, Sudan

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20211393

Keywords:

Keratoconus, Eye rubbing, Allergic rhinitis, Eczema, Asthma, Atopy

Abstract

Keratoconus (KN), is an eye disorder, characterized by progressive thinning and protrusion of central cornea. A number of conditions such as such as allergy, asthma, eczema, and eye rubbing has been shown to be associated with the development of KN. However, there is a disagreement regarding some of risk factors and their strength so we conducted systematic review and meta-analysis to determine how strongly risk factors such as eye rubbing, and atopic triad associate with KN development and progression. We systematically searched the literature for related studies using specific keywords and key phrases. The studies were scrutinized based on inclusion and exclusion criteria. Finally, we extracted relevant qualitative and quantitate information from studies. For meta-analysis we used odds ratio (OR) and their 95% CI were used to draw forest plots. 35 studies were selected in final meta-analysis. Our meta-analysis yielded the combined effect of risk factors with OR of 2.20 and a 95% CI of 1.84–2.64. Furthermore, we found that eye rubbing-related studies had effect size of OR 2.09 with a 95% CI of 1.76–2.49 and a p value of 0.00001. For atopic triad (allergic rhinits, asthma and eczema) related studies, the meta-analysis yielded overall effect size of OR 2.34 with 95% CI of 2.06-2.66. Eye rubbing and atopic triad (allergic rhinitis, eczema, and asthma) are important risk factors for KC development with statistically strong association.

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