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Nicole Langelier, Mina Massaro-Giordano, Gui-Shuang Ying, Jiayan Huang, Vatinee Y. Bunya; Tear Osmolarity and Dry Eye Symptoms in Diabetics and Non-Diabetics. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3792.
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To assess any differences between diabetics and non-diabetics in tear osmolarity, dry eye symptoms, and their associated factors.
Twenty nine diabetic patients and forty two non-diabetic patients were enrolled. Medical history was obtained and symptoms were assessed using the Ocular Surface Discomfort Index (OSDI). Tear osmolarity of each eye was measured with the TearLab osmolarity system. Each subject’s average osmolarity score was used for data analysis.
The diabetic cases and non-diabetic controls were similar in age (55 ± 5 vs. 54 ± 14 years; p=0.23) and gender (24.1% vs 16.7% male; p=0.55), but there was a higher percentage of African American subjects among cases compared to controls (55.6% vs 33.3%; p=0.005).The correlation between osmolarity score and OSDI score was weak (r=-0.10, p=0.41) among all study participants, yet marginally significant (r=-0.31, p=0.098) among diabetic cases. The differences between diabetics and non-diabetics were small for both tear osmolarity (302 ± 2.0 vs. 300 ± 1.7 mOsm, p=0.66) and OSDI score (7.2 ± 1.3 vs. 8.9 ± 1.1, p=0.33). Adjustment by other covariates including gender and race did not substantially change their differences.Subjects with primary Sjögren’s disease (n=5) had a higher osmolarity than subjects without primary Sjögren’s disease (309 ± 4.7 vs. 300 ± 1.3 mOsm, p=0.09).Multivariate analysis revealed that some factors were associated with higher OSDI score, including female gender (n=57, p=0.06), presence of blepharitis (n=6, p=0.10), primary Sjögren’s disease (n=5, p=0.02), use of artificial tear therapy (n=32, p=0.04), Restasis use (n=7, p=0.09), and use of >2000mg of fish oil daily (n=7, p=0.001).
There was no difference in tear osmolarity and OSDI score between diabetic and non-diabetic subjects. Female gender and use of dry eye treatment modalities was associated with a higher OSDI score. In contrast to previous research, there was a marginally significant negative correlation between tear osmolarity and OSDI score among diabetic patients.
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