Retracted: The association between keratoconus and allergic eye diseases: A systematic review and meta‐analysis

Abstract

Background: To investigate association between keratoconus and allergic eye diseases, eye rubbing, and atopy.Methods: PubMed, Web of Science, Scopus, and Cochrane were searched for relevant published studies from inception to April 2021 without restrictions or filters. We included case-control, cohort, and cross-sectional studies that investigated eye allergy, atopy, or eye rubbing as possible risk factors for KC. Two authors independently screened all titles and abstracts against predefined inclusion and exclusion criteria. This study analysed keratoconus prevalence and risk factors including eye rubbing, family history of keratoconus, atopy, and allergic eye diseases. The National Institute of Health Study Quality Assessment tool was utilised. Pooled data were presented as odds ratio (OR) and 95% confidence intervals (CI). Analysis was conducted using RevMan version 5.3 software.Results: Out of 573 articles, we excluded 161 duplicates than 361 articles by title and abstract screening. The remaining 51 articles underwent full-text screening, and 29 articles were excluded. Twenty-one studies were included in the qualitative synthesis and fifteen for quantitative synthesis. There was no significant association found between KC and allergic eye diseases (OR = 1.03, 95% CI [0.96, 1.11], p = 0.45), eye rubbing (OR = 1.59, 95% CI [0.70, 3.63], p = 0.27), or atopy (OR = 1.08, 95% CI [0.80, 1.44], p = 0.62). Conclusion:No significant association was observed between KC and allergic eye disease, eye rubbing, or atopy. Further prospective studies are needed to clarify and validate these findings. K E Y W O R D S allergy, atopy, eye rubbing, keratoconus, vernal conjunctivitis 1 | INTRODUCTION Keratoconus (KC) is a corneal disorder characterised by progressive thinning and cone-shaped protrusion of the cornea leading to significant visual impairment. 1 KC usually occurs bilaterally but its severity and progression differ between eyes. 2 These morphological changes promote a range of visual disturbances, with patients suffering

Independent and interactive effects of eye rubbing and atopy on keratoconus

“…The association between atopy and KC has been reported since the beginning of the 20th century, and many conflicting reports have been published (23,24). The present study showed that atopy was a risk factor for KC, consistent with a study by Millodot et al (23) In contrast, no significant association has been demonstrated between atopy and KC in other studies (9,14,24). The variations in definitions, populations heterogeneity, and duration of atopy may arise from the conflicting results of different studies (25).…”

“…Advising KC patients to stop eye rubbing has been a common recommendation, and the association between eye rubbing and KC has been widely studied in the past (12)(13)(14)(15). Some cases of unilateral KC have been reported to have developed in response to a unilateral habit of eye rubbing, which indicated that there might exist a strong association between eye rubbing and KC (16)(17)(18)(19)(20).…”

“…In addition, Sahebjadah et al (13) conducted a meta-analysis including six case-control studies and found that eye rubbing was positively associated with KC. However, a recent metaanalysis reported no significant association between eye rubbing and KC, with one prospective cohort study, three cross-sectional studies, and seven case-control studies (14). The heterogeneity between different studies prompted researchers to further explore the association between eye rubbing and KC.…”

“…In addition, atopy is an important condition for KC, and the association between atopy and KC has been evaluated for many years ( 9 , 22 ). Although atopy has been suggested as a risk factor for KC ( 23 ), several recent studies failed to demonstrate the association ( 4 , 14 ). Multifactor analysis, including eye rubbing and atopy, showed that eye rubbing was still a risk factor for KC ( 14 , 24 , 25 ).…”

‘Aye, there's the rub’—Ocular allergy and keratoconus

“…We congratulate Seth et al 4 for the publication of “The association between keratoconus and allergic eye diseases: A systematic review and Meta‐analysis” in this issue of Clinical and Experimental Ophthalmology . The authors screened 361 titles and abstracts to include 15 observational studies (10 case–control, 5 cross‐sectional) with 708 225 participants (20 336 of them had keratoconus) in quantitative meta‐analyses; and 7 studies (6 cross‐sectional, 1 basic science) with 899 participants (709 of them had keratoconus) in descriptive analyses.…”