Abstract
Purpose :
Type 2 diabetes (DM2) is a known risk factor for dry eye disease. The aim of the study was to explore symptoms and signs of dry eye disease (DED) in people with DM2.
Methods :
In all, 89 participants with DM2 underwent an extensive eye examination, including a dry eye work-up at the University of South-Eastern Norway during the period August 2018 to June 2019. The dry eye work-up included OSDI questionnaire and assessment of homeostasis markers described in the Tear Film and Ocular Surface Society (TFOS) Dry eye Workshop (DEWS) II report. In addition, dry eye subtype classification tests: tear meniscus height, meibum expressibility and quality, and Schirmer test were performed. Data were analyzed using standard statistical tests: Chi-square and logistic regression. A p-value < 0.05 was considered significant. The study was approved by the Regional Committees for Medical Research Ethics.
Results :
The mean (sd) age of the patients was 65 (±10) years, 39 (44%) were female. Their mean (sd) duration of diabetes was 10 (±7) years. In all, 16 (18%) reported dry eye symptoms (OSDI-score ≥ 13), of these 10 had mild, 2 had moderate and 4 had severe dry eye symptoms, respectively. The majority of the participants (n=78) had at least one positive homeostasis marker, 66 had ocular surface staining > 5 corneal spots, > 9 conjunctival spots or lid margin staining > 2 mm and ≥ 25% width, 56 had osmolarity ≥ 308 mOsm/L in either eye or intraocular difference > 8 mOsm/L, and 41 had Non-Invasive Tear Breakup Time (NIBUT) < 10 seconds. Participants without dry eye symptoms had more often reduced NIBUT than participants with dry eye symptoms, 37 (54.4%) versus 4 (25.0%), respectively (X2 (1, N=84) = 4.484, p = .034). According to DEWS II diagnostic criteria, 16 (18%) had DED. Dry eye symptoms and DED were not associated with duration of DM2 (>10 years). In all, 57 had Schirmer test < 10 mm, 12 tear meniscus height < 0.2 mm, and 31 had meibomian gland dysfunction (MGD), of whom 10, 2 and 9, respectively had DED according to DEWS II diagnostic criteria. Schirmer test < 10 mm, tear meniscus height < 0.2 mm, and MGD were not associated with dry eye symptoms or duration of DM2.
Conclusions :
The OSDI questionnaire is not a sufficient screening tool to detect DED in people with DM2. People with DM2 should be examined routinely for ocular surface signs and DED to prevent serious complications and reduced vision.
This is a 2020 ARVO Annual Meeting abstract.