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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.039 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.031 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".