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Peter Reinach, Jacqueline Faustino, Monica Alves, Danilo Ribeiro, Jayter Paula, Eduardo Rocha, ; Clinical Correlations Among Dry Eye Tests, Physical And Metabolic Findings In Diabetes Mellitus Patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6047.
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To determine in diabetes mellitus (DM) patients, without proliferative retinopathy, if there are specific sets of ocular surface signs and/or body mass indices as well as clinical laboratory results that correlate with dry eye disease (DED) diagnosis.
Ocular surface dye staining and tear film osmolarity (TFOsm) evaluation were performed (TearLab Osmometer). These results were tested for correlation with measurements of either: a) body mass index; (BMI); b) thoracic and abdominal circumference (TC, AC, respectively); c) triceps crease width or; d) blood glycated hemoglobin (HbA1c) level and hyperglycemia.
In 27 DM patients, 55.+- 19 years old, 20 were DM2 whereas 7 others were DM1. Out of both groups, 85% were diagnosed with DED (DM1 and 2 in 75% and 90%, respectively). Most common ocular DED signs were: TFBUT (56%) and tear hyperosmolarity (52%). The most relevant systemic correlations in DM2 patients were between: number of systemic medications or AC and elevated TFOsm (r=0.48, p= 0.044; r=-0.724, p=0.0007, respectively), Ocular Surface Disease Index score with: a) TFBUT and AC (r=0.64, p=0.0044; r=0.5, p=0.033, respectively); b) lissamine green and fluorescein staining (r=0.739, p= 0.0005). However, neither HbA1c,BMI nor triceps crease width correlated with any of the ocular surface or DED parameters.
DM1 and 2 highly correlate with DED. In DM2, abdominal fat accumulation correlates best with tear film hyperosmolarity and ocular surface integrity damage. Such correlations in DM2 patients suggest that specific metabolic changes may promote DED development.
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