The Use of Medicinal Plants in Common Ophthalmic Disorders: a Systematic Review With Meta-analysis

Background: There is rare information regarding the use of Medicinal Plants For Ocular Diseases. This study aimed to assess and compile the available research articles about medicinal plants used for ocular diseases. Methods: The PICOS as a search term were used to design a clear answerable study question. the studies were retrieved by searching in four selected databases; PubMed, science direct, and the American Academy of Ophthalmology (AAO), using well-designed and optimized filters. while the Prisma flowchart was applied and the quality of the included studies was assessed. meta-analyses were performed to calculate the pooled odds ratios (ORs) or standardized mean (SM) for included studies for each outcome, using both fixed and random-effect approaches through constructing the relevant forest plot. the heterogeneity of the studies was determined by estimating both Q and I 2 parameters. Moreover, the funnel plot was used to test the publication bias. Results: A Prisma flow chart revealed that; a total of 2,949 articles were retrieved, 35 full-text were assessed for eligibility and seven studies (4 observational and 3 experimental) with low to moderate quality were eligible and involved in the systematic review with a total of 600 plants from 4 countries. Among the 600 plants, only 24 (4%); were used to assess the status, both the fixed and random models of the studies proved that, the included studies have a tendency to predict the outcomes for the observational studies (OR= 0.062, CI= 0.043- 0.090 and OR= 0.039, CI= 0.012- 0.122) for different plants used for ocular diseases. High heterogeneity (estimated as I 2 =87.078, Tau 2 = 1.161 and Q-value =23.217 with p-value of 0.000). whilst for experimental studies (I 2 =94.928, Tau 2 = 23.211 and Q-value =39.434 with p-value of 0.000) and publication bias were reported. Conclusions: Few articles that represent about 600 plants with low to moderate quality reported the use of medicinal plants for ocular diseases. The meta-analysis confirmed the systematic review findings regarding the plants' traditional use with high heterogeneity and publication bias. A considerable gap was proved towards the use of medicinal plants in ocular diseases that require intensive research.