[Evaluation of the tear film function in diabetic patients using the Keratograph 5M]

Objective: To evaluate the tear film function of diabetic patients using the Keratograph 5M and to analyze its related factors. Methods: Case-control study. A total of 89 inpatients (174 eyes) diagnosed with diabetes in the Department of Endocrinology at our hospital were recruited. According to the fundus fluorescein angiography results, subjects were divided into two groups, diabetic retinopathy (DR) group and none-DR group. All subjects were examined for duration of diabetes, glycosylated hemoglobin, creatinine, 24-hour urinary protein, and 24-hour urinary microalbumin/urinary creatinine, and by electromyography. The Keratograph 5M was used to obtain the first and average tear film break-up time (BUTf and BUTav), tear meniscus height, the upper and lower meibomian gland loss scores. The data were analyzed by SPSS. Results: Compared to the non-DR group, the BUTf and the BUTav in the DR group were shorter [(8.42±4.71) s vs. (10.24±5.32) s, (11.20±5.25) s vs. (12.67±5.52) s; P=0.000]. There was no significant difference in the tear meniscus height between the three groups (P=0.067). The tear meniscus height were negatively related with glycosylated hemoglobin, and not related with duration of diabetes, 24-hour urinary microalbumin/urinary creatinine, creatinine, 24-h urinary protein, and electromyography results. As the duration of diabetic longer, the upper and lower meibomian gland loss scores added(Z=19.514, 15.342, P<0.05). Patients with EMG abnormal, the lower meibomian gland loss scores added(Z=-2.312, P<0.05). Conclusions: The Keratograph 5M can directly evaluate the tear film condition of diabetic patients.Diabetic patients with retinopathy and higher glycosylated hemoglobin tend to suffer tear film dysfunction. (Chin J Ophthalmol, 2018, 54:762-766).