Dry eye syndrome: an underappreciated extraintestinal manifestation of inflammatory bowel disease? A systematic review and meta-analysis
Bibliographic record
Abstract
Objective Ocular extraintestinal manifestations (O-EIMs) of inflammatory bowel disease (IBD) are known to include uveitis, scleritis and episcleritis; however, the relationship of dry eye syndrome (DES) with IBD is unclear. We aimed to determine if IBD is associated with DES. Design/method A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, searching four databases for studies comparing DES in patients with IBD versus non-IBD. OR and weighted mean differences (WMDs) of objective ocular parameters (ie, Schirmer I test (tear production); tear breakup time (TBUT; tear film stability) and Ocular Surface Disease Index (OSDI; dry eye symptom rating scale)) were meta-analysed using a random-effects model. Results We included eight cohort studies for a total of 55 211 patients with IBD and 54 870 patients without IBD. Compared with non-IBD controls, patients with IBD had significantly increased odds of DES (OR=2.54; 95% CI: 1.47 to 4.36, p=0.0008) and increased OSDI score (WMD=4.57 points, 95% CI: 1.80 to 7.35, p=0.0012). For the Schirmer I test, patients with IBD had significantly lower tear production compared with controls (WMD=−3.63 mm, 95% CI: −5.52 to −1.74, p=0.0002). For TBUT, patients with IBD had greater tear film instability compared with controls (WMD=−3.33 s, 95% CI: −4.97 to −1.70, p<0.0001). Conclusions DES may be an underappreciated EIM of IBD. Clinicians should consider screening for the presence of DES during a review of EIMs, as treatment of DES can significantly improve quality of life. PROSPERO registration number CRD420251076843.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".