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Meta-Analysis
. 2024 Jan 5;19(1):e0296784.
doi: 10.1371/journal.pone.0296784. eCollection 2024.

Quantitative changes in the corneal endothelium and central corneal thickness during anterior chamber inflammation: A systematic review and meta-analysis

Germán Mejía-Salgado  1   2 , Paula Tatiana Muñoz-Vargas  3   4 , Carlos Cifuentes-González  1   3   4 , Gabriela Flórez-Esparza  2 , Rebeca Paquentín-Jiménez  5 , Miguel Ángel Castro-Monreal  5 , Naomi Medina-Galindo  5 , Gilma Norella Hernández-Herrera  3   4 , Luz Elena Concha-Del-Río  5 , Alejandra de-la-Torre  2   4
Affiliations
Meta-Analysis

Quantitative changes in the corneal endothelium and central corneal thickness during anterior chamber inflammation: A systematic review and meta-analysis

Germán Mejía-Salgado et al. PLoS One. .

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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
Fig 2
Fig 2. Effects of uveitis on morphological endothelial parameters.
Fig 3
Fig 3. Funnel plots.
Fig 4
Fig 4. Effects of inflammatory activity on endothelial parameters and central corneal thickness.
Fig 5
Fig 5. Effects of ACI course on endothelial parameters and corneal thickness.
See this image and copyright information in PMC

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