Ocular Manifestations of Psoriasis: A Systematic Review

Psoriasis, a chronic inflammatory skin disease, manifests itself by an array of immunological and inflammatory alterations. Ocular involvement can occur through a variety of pathways, notably direct interaction with psoriatic plaques or psoriasis-associated inflammatory responses. The present systematic review was intended to more effectively comprehend and describe the prevalent nature of psoriasis ocular symptoms by tracking all relevant studies published over the last decade and carefully synthesizing their findings. This systematic review was performed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study selection, synthesis, and reporting of results. The PubMed, Cochrane, and Scopus databases were used to search for evidence-based research papers on psoriasis ocular symptoms published between January 2012 and August 2023. The prevalence of ocular manifestations in psoriasis varied between the studies ranging from 81.4% to 10%. The increase in the ocular symptoms with prolonged duration of psoriasis was statistically significant. Dry eye condition is the most prevalent clinical ocular alteration related to psoriasis. Blepharitis, conjunctivitis, keratopathy, and uveitis were common in psoriasis patients. Higher intraocular pressure and glaucoma were reported. Physicians should keep in mind and look for ocular associations in Psoriasis patients. Addressing the crucial stages in the pathophysiology of ocular alterations is essential for targeted efforts for immunotherapeutic management. Interventions are shifting away from broad immunosuppression towards the administration of particular biologicals that target specific components of the immune response.银屑病（Psoriasis）是一种慢性炎症性皮肤病，以一系列免疫与炎症改变为主要临床表现。眼部受累可通过多种途径发生，尤其包括与银屑病皮损的直接接触，或由银屑病相关的炎症反应介导。本系统综述旨在通过追踪近十年发表的所有相关研究并严谨整合其研究结果，更全面地理解并阐明银屑病眼部症状的流行特征。本系统综述严格遵循《系统综述与Meta分析优先报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南开展研究筛选、结果整合与报告工作。本研究检索了PubMed、Cochrane与Scopus数据库，筛选2012年1月至2023年8月期间发表的、关于银屑病眼部症状的循证研究论文。不同研究报道的银屑病患者眼部表现患病率差异较大，区间为10%至81.4%。银屑病病程越长，眼部症状发生率越高，该关联具有统计学意义。干眼症是与银屑病关联最普遍的眼部临床改变。睑缘炎、结膜炎、角膜病变与葡萄膜炎在银屑病患者中较为常见。研究还报道了高眼压与青光眼的发生情况。临床医师应警惕并主动筛查银屑病患者的眼部并发症。明确眼部病变病理生理学的关键环节，是开展针对性免疫治疗的核心前提。当前治疗策略正从广谱免疫抑制，转向针对免疫应答特定靶点的特异性生物制剂给药方案。