Abstract
Purpose :
To enhance our understanding of Dry Eye (DE) in Type 2 Diabetes (T2D) by assessing panels of tear fluid inflammatory cytokines and metabolic proteins, alongside ocular surface health parameters. In addition, the study aimed to detect how DE affects the Quality of Life (QoL) of subjects in these study groups.
Methods :
Subjects were divided into 4 groups: T2D+DE (n=6); T2D-only (n=4); DE-only (n=4) and healthy controls (n=7). All subjects completed the Ocular Surface Disease Index (OSDI) and Dry Eye-Related Quality of Life (DEQS) questionnaires and underwent the Schimer I test, Non-Invasive Tear Break Up Time (NITBUT) and Corneal Fluorescein Staining (CFS). Inflammatory cytokines (EGF, Fractalkine, IFN-γ, IL-10, IL-17A, IL-1RA, IL-1β, IL-2, IL-4, IL-6, IL-8, IP-10, MCP-1, TNF-α, VEGF) and metabolic proteins (C-Peptide, Ghrelin, GIP, GLP-1, Glucagon, Insulin, Leptin) were analysed by Multiplex magnetic bead analysis.
Results :
The DEQS score was significantly higher in the T2D+DE group than the other three groups (p=0.012 versus T2D-only, p=0.046 versus DE-only and p=0.003 versus healthy controls). IL-6, IP-10 and C-Peptide levels were highest in the T2D+DE group. In the DE-only group, IL-8, VEGF and Glucagon were higher than other three groups. In the T2D+DE group, tear fluid Fractalkine, IL-1β and Insulin levels negatively correlated with the NITBUT value. For the T2D+DE, EGF, IL-1RA and Leptin levels negatively correlated with the Schirmer score and IL-4 levels positively correlated with the OSDI score. In the T2D-only group, Leptin positively correlated with Schirmer and negatively correlated with OSDI. In the DE-only group, Leptin and EGF levels positively correlated with NITBUT. In addition, there was a positive correlation between IL-6 levels and CFS for the DE-only group.
Conclusions :
In those with T2D+DE, QoL is significantly worse. IL-6, IP-10 and C-Peptide have potential to be diagnostic biomarkers of T2D-related DE. This suggests that there may be a different pathogenesis underpinning DE in T2D versus DE in non-diabetic subjects. Further investigations are needed in larger patient cohorts.
This is a 2020 ARVO Annual Meeting abstract.