Objective To conduct a review and meta-analysis for investigating the relative reduction of central corneal basal cell density (BCD) and nerve parameters in ocular surface disease (OSD) and limbal stem cell deficiency (LSCD).
Methods A systematic literature search using the terms ((1) “ocular surface disease” or “ocular surface disorder”; (2) “in vivo confocal microscopy”; (3) “limbal stem cell deficiency”; (4) “basal cell density” or “corneal basal cell density” or “central corneal basal cell density”; (5) “corneal nerves” or “corneal nerve parameters” or “central corneal nerve parameters”) was performed. The results are presented as weighted mean difference (WMD) with corresponding 95% CI.
Results 16 studies that reported the central corneal BCD and 21 studies that reported the central corneal nerve parameters in OSD (including LSCD) were included. A significant reduction in central corneal BCD was observed in patients with various OSDs (WMD=−9.50, 95% CI −14.04 to −4.97, p<0.01) as well as in patients with LSCD (WMD=−22.14, 95% CI −37.91 to −6.37, p<0.01) compared with healthy controls, however, no significant difference in BCD was observed between the two groups (WMD=−11.61, 95% CI −15.96 to −7.26, p=0.13). There was no conclusive difference in various central corneal nerve parameters between OSDs and LSCD.
Conclusion Central corneal BCD and nerve parameters are reduced in LSCD, there is a similar reduction in other OSDs.
- ocular surface
- stem cells
- diagnostic tests/investigation
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Contributors PB, KE, DH and KLS: contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript.
Funding PB is supported by an Australian Government Research Training Program (RTP) Stipend (International) and QUT HRD Tuition Fee Sponsorship administered by the Queensland University of Technology.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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