Association between Helicobacter pylori infection and primary open angle glaucoma: a Meta analysis

Abstract

Background The incidence of primary open angle glaucoma (POAG) is increasing in recent years.To study the risk factors of POAG pathogenesis is of great significance. Objective This study was to explore the association between Helicobacter pylori infection and POAG pathogenesis. Methods The Chinese and English literature about Helicobacter pylori infection and pathogenesis from January 2000 to February 2015 was searched in PubMed, Embase, The Cochrane Library, VIP, Wanfang database and CNKI database with computer and supplemented by the relevant references, and these cases-control studies were evaluated using the Newcastle-Ottawa Scale (NOS). The odds ratio (OR) and 95% confidence interval (CI) were calculated by using Stata 12.0 statistical software.Sensitivity analysis and subgroup analysis were used to process the heterogeneity (I2) among the studies.The effect size was analyzed using the randomized model in I2≥50% and fixed model was used in I2<50%. Results Eight cases-control studies from Erope, Asia and North America were included with the NOS scores ≥ 5.The examination methods for Helicobacter pylori included ELISA, Western blot and histopathology among the articles.Helicobacter pylori infection rate was 71.38% (197/276) in the POAG group, and that in the control group was 42.90% (151/352). Randomized model analysis showed a significant association between Helicobacter pylori infection and POAG pathogenesis (OR=3.23, 95%CI: 1.65-6.23, P=0.001). No obvious interference from any paper was found by sensitivity analysis.The subgroup analysis based on different areas found that Helicobacter pylori infectious rate of POAG patients was highest in Europe area (OR=7.25, 95%CI: 3.61-14.54, P=0.000, I2=0.0%), the subgroup based on different detect methods found that histopathological examination had the highest detected rate of Helicobacter pylori (OR=9.13, 95%CI: 3.78-22.04, P=0.000, I2=0.0%), and the next was ELISA assay (OR=2.85, 95%CI: 1.40-5.81, P=0.004, I2=60.4%). No published bias was seen by funnel plots and Egger linear analysis. Conclusions Helicobacter pylori infection is associated with POAG pathogenesis. Key words: Glaucoma, open angle; Helicobacter infections/epidemiology; Helicobacter pylori/immunology; Case-control studies; Meta analysis; Humans