Psoriasis and Dry Eye Disease: A Systematic Review and Meta-Analysis

Psoriasis is a chronic inflammatory skin disease with potential systemic involvement. Some evidence suggests an increased risk of dry eye in patients with psoriasis. However, the relationship between these two conditions remains unclear. The aim of our study is to investigate the association between psoriasis and dry eye disease.This meta-analysis was registered in PROSPERO (CRD42020199445) and adhered to MOOSE checklist and PRISMA guidance for all processes. PubMed, Embase, Web of Science, and Cochrane databases were searched for studies examining the association between psoriasis and dry eye disease from inception to December 13, 2020. The primary outcome was the prevalence of dry eye disease in patients with psoriasis relative to controls. The secondary outcomes were the Schirmer I test score, tear film breakup time (TBUT), and ocular surface disease index (OSDI). The risk of bias of the selected studies was assessed using the Newcastle-Ottawa Scale.The meta-analysis showed a significant association between dry eye disease and psoriasis (OR, 8.49; 95% CI, 3.34-21.58). Moreover, patients with psoriasis had a significantly lower Schirmer I test score (MD, -2.80; 95% CI, -4.07 to -1.52), shorter TBUT (MD, -4.12; 95% CI, -5.22 to -3.02), and higher OSDI (MD, 20.15; 95% CI, 6.24-34.05; p < 0.01), compared to controls.The current evidence supports an association between dry eye disease and psoriasis. These results suggest ophthalmologic assessment for the early recognition and management of dry eye in patients with psoriasis.