Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus.

Area of Science:

• Ophthalmology
• Diabetology
• Cell Biology

Background:

• Diabetes mellitus is a systemic disease with known ocular complications.
• Ocular surface disorders are increasingly recognized in diabetic patients.
• Understanding these disorders is crucial for comprehensive diabetes care.

Purpose of the Study:

• To characterize the ocular surface disorder in patients with diabetes.
• To investigate the relationship between ocular surface changes and diabetic complications.

Main Methods:

• A prospective, case-controlled study involving 50 diabetic patients and 20 healthy controls.
• Ophthalmic examinations, corneal sensitivity, Schirmer test, tear film break-up time (BUT), and conjunctival impression cytology were performed.
• Analysis included comparisons of ocular surface parameters and their correlation with diabetic peripheral neuropathy, metabolic control, disease duration, and retinopathy status.

Main Results:

• Diabetic patients showed significantly lower corneal sensitivity, BUT, and Schirmer test values compared to controls.
• Conjunctival impression cytology revealed goblet cell loss and squamous metaplasia in diabetic patients.
• These ocular surface changes correlated with peripheral neuropathy, poor metabolic control, and reduced corneal sensitivity, but not with disease duration or retinopathy status.

Conclusions:

• Diabetic ocular surface disease is characterized by impaired tear quantity and quality, goblet cell loss, and squamous metaplasia.
• These findings are closely associated with the patient's metabolic control status and the presence of peripheral neuropathy.
• Management of metabolic control and neuropathy may be key in addressing ocular surface issues in diabetes.