Tear film and ocular surface dysfunction in diabetes mellitus in an Indian population

Divya Kesarwani, Syed Wajahat Ali Rizvi, Adeeb Alam Khan, Abadan Khan Amitava, Shaista Manan Vasenwala, Ziya Siddiqui, Divya Kesarwani, Syed Wajahat Ali Rizvi, Adeeb Alam Khan, Abadan Khan Amitava, Shaista Manan Vasenwala, Ziya Siddiqui

Abstract

Purpose: Ophthalmic complications in diabetes such as retinopathy, cataract, and infections have been extensively studied. Recently, attention has been drawn toward ocular surface changes in diabetes mellitus (DM). This study has been carried out to investigate the tear film and ocular surface abnormalities in type II DM patients.

Materials and methods: A total of 83 participants (130 eyes) were enrolled: 53 diabetics (80 eyes) and 30 healthy controls (50 eyes). Of the 53 diabetics, 24 patients (42 eyes) had some diabetic retinopathy. The tear film and ocular surface were evaluated using Schirmer test, tear film break-up time (TBUT), keratoepitheliopathy score (KES), Rose Bengal Staining (RBS) test, and conjunctival impression cytology.

Results: When compared with the healthy controls, diabetics showed significantly reduced Schirmer, TBUT measurements and the higher grades of KES and RBS test (P < 0.001). Impression cytology analysis showed goblet cell loss and conjunctival squamous metaplasia in diabetics.

Conclusion: Tear film abnormality is a significant feature of diabetic ocular surface diseases. These abnormalities are likely on account of poor quality and function of tears, combined with the subnormal ocular surface. Therefore, all diabetic patients especially those with evidence of retinopathy changes should undergo routine early examination and follow-up of tear function and ocular surface parameters.

Conflict of interest statement

There are no conflicts of interest.

References

    1. Saini JS, Khandalavla B. Corneal epithelial fragility in diabetes mellitus. Can J Ophthalmol. 1995;30:142–6.
    1. Inoue K, Kato S, Ohara C, Numaga J, Amano S, Oshika T. Ocular and systemic factors relevant to diabetic keratoepitheliopathy. Cornea. 2001;20:798–801.
    1. Chous P. Dry Eyes and Diabetes Often Go Hand in Hand: dLife Blog. Connecticut: LifeMed Media, Inc; 2013. [Last cited on 2015 Oct 02]. Available from: .
    1. Grading diabetic retinopathy from stereoscopic color fundus photographs – An extension of the modified Airlie House classification. ETDRS Report Number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98(5 Suppl):786–806.
    1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33:S62–9.
    1. Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology. 2001;108:586–92.
    1. Jones LT. The lacrimal secretory system and its treatment. Am J Ophthalmol. 1966;62:47–60.
    1. van Bijsterveld OP. Diagnostic tests in the sicca syndrome. Arch Ophthalmol. 1969;82:10–4.
    1. Anshu, Munshi MM, Sathe V, Ganar A. Conjunctival impression cytology in contact lens wearers. Cytopathology. 2001;12:314–20.
    1. Nelson JD. Impression cytology. Cornea. 1988;7:71–81.
    1. Goebbels M. Tear secretion and tear film function in insulin dependent diabetics. Br J Ophthalmol. 2000;84:19–21.
    1. Ozdemir M, Buyukbese MA, Cetinkaya A, Ozdemir G. Risk factors for ocular surface disorders in patients with diabetes mellitus. Diabetes Res Clin Pract. 2003;59:195–9.
    1. Yoon KC, Im SK, Seo MS. Changes of tear film and ocular surface in diabetes mellitus. Korean J Ophthalmol. 2004;18:168–74.
    1. Li HY, Pang GX, Xu ZZ. Tear film function of patients with type 2 diabetes. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2004;26:682–6.

Source: PubMed

3
Abonnieren