Abstract
Purpose :
To asses the meibomian glands, ocular surface and tear function in patients with type 2 diabetes.
Methods :
Prospective study of 76 subjects, 37 with diabetes type 2, and 36 healthy (control group). After completing an ocular surface disease index (OSDI) questionnaire and the National Eye Institute Vision Functioning Questionnaire (NEI-VFQ), the non -invasive tear film break-up time (NI-BUT) and the tear lipid layer pattern was performed using interferometry system (Polaris ®) and tear meniscus height/TMH was measured with optical coherence tomography/OCT. Ocular surface state was studied with lissamine green staining and morphology of the glands with evaluation of Marx’s line (lid margin abnormalities); meibomian secretion was expressed and was also assessed the quality.The results were analyzed using the statistical Kruskal-Wallis and Mann-Witney, and correlations by Spearman Rho.
Results :
The mean age was 59 ± 8 years; only subjects of male gender were included. 71% of participants presented MGD (76% diabetics and 67% healthy participants). Symptoms through OSDI questionnaire were significantly higher (p=0.016) in the diabetic group with a lower NEI-VFQ (67.86; p = 0.002). A positive correlation was found between glicemia and symptoms and life quality NEI-VFQ, in 60-64 years old subjects (p=0.0005). NIBUT was lower in diabetic patients (2.47 ± 1.2 sg), with a significant inverse correlation (52.22%) with MG inflammation. The lid margin abnormality score (hyperkeratinisation and inflammation) was significantly higher in the diabetic group than in the nondiabetic group (p=0.0005) with toothpaste’s type secretions (75%). There was no statistically significant difference in the TMH, lissamine staining, between groups.
Conclusions :
Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. Longer duration of diabetes is associated with major symptoms and changes in meibomian glands. Diabetic group showed major changes in lids and tear function, accounting for evaporative dry eye and presenting a high degree of correlation with MG inflammation and obstruction. The value of Hb1Ac has a high degree of correlation with the NEI-VFQ in patients with DGM. Symptoms were significative higher in diabetic group than healthy participants.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.