| Objective:To explore the influence of the duration of diabetes and the level of glycosylated hemoglobin(Hb A1c)on the ocular surface related indicators of type 2 diabetes patients with dry eyes,and to compare the ocular surface between diabetes patients without obvious dry eye symptoms and healthy people.To explore the pathogenesis and clinical characteristics of dry eye in type 2 diabetes,so as to provide help for accurate diagnosis and targeted prevention of dry eye in type 2 diabetes population.Methods:227 subjects were included in this study,128 patients with type 2 diabetes(diabetes group),62 dry eye patients without diabetes(non diabetes dry eye group),At the same time,37 normal people(normal control group)were selected as the study subjects,Select the right eye as the observation eye.All Participants were evaluated with the ocular surface disease index(OSDI)questionnaire,non-invasive tear breakup time(NIBUT-1st and NIBUT-avg),tear meniscus height(TMH),conjunctival hyperemia score,schirmer I test(SIt),corneal fluorescein staining(CFS),lipid layer thickness score,eyelid margin abnormal morphology scores,meibomian gland yielding secretion score(MGYSS),percentage of meibomian gland partial(MGP).The duration and Hb A1 c of diabetes patients were recorded at the same time.According to the above dry eye related examination results,the diabetes group is divided into diabetes dry eye group and diabetes non dry eye group.To observe the influence of diabetes duration and Hb A1 c level on the ocular surface of diabetes patients with dry eyes.The ocular surface related indexes of subjects in short duration diabetes dry eye group(diabetes duration<10 years),long duration diabetes dry eye group(diabetes duration ≥ 10 years)and non diabetes dry eye group were compared.The eye surface related indexes of low Hb A1 c diabetes dry eye group(Hb A1c<7),high Hb A1 c diabetes dry eye group(Hb A1 c ≥ 7)and non diabetes dry eye group were compared.Finally,the ocular surface related index of the diabetes non dry eye group and the normal control group who had no obvious dry eye symptoms were compared.Results:(1)Compared with the non diabetes dry eye group,the NIBUT-1st of the short duraton and long duration diabetes dry eye group was shorter,MGP of right lower Meibomian gland was higher,and right upper and right lower eyelid margin abnormal morphology scores was higher(p<0.05),But there was no significant difference between short course and long duration diabetes dry eye groups(p>0.05).NIBUT-avg in the long duration diabetes dry eye group was significantly shorter than non diabetes dry eye group(p<0.05),but there was no significant difference between the long duration and short duration diabetes dry eye groups(p>0.05).The MGYSS and MGP of right upper meibomian gland in the long duration diabetes dry eye group were significantly higher than those in the short duration diabetes dry eye group and non diabetes dry eye group(p<0.05).There were no statistically significant differences among the three groups in terms of OSDI scores,TMH,lipid layer thickness scores,SIt,CFS,and conjunctival hyperemia score(p>0.05).(2)Compared with the non diabetes dry eye group,NIBUT-1st was shorter in the low Hb A1 c and high Hb A1 c diabetes dry eye groups,and MGP of the right upper and right lower meibomian glands,right upper and right lower eyelid margin abnormal morphology scores were higher(p<0.05),However,there was no significant difference between low Hb A1 c and high Hb A1 c diabetes dry eye groups(p>0.05).The MGYSS in the high Hb A1 c diabetes dry eye groups was significantly higher than non diabetes dry eye group(p<0.05),However,there was no significant difference between low Hb A1 c and high Hb A1 c diabetes dry eye groups(p>0.05).There was no statistically significant difference among the three groups in terms of OSDI score,TMH,NIBUT-avg,lipid layer thickness score,SIt,CFS,and conjunctival hyperemia score(p>0.05).(3)Compared to the normal control group,The decreased of OSDI score,CFS elevated.MGYSS,MGP of the right upper and right lower meibomian glands,right upper and right lowe eyelid margin abnormal morphology scores also elevated,NIBUT-1st and NIBUT-avg significantly shortened,TMH and lipid layer thickness score decreased(p<0.05).There was no significant difference between SIt and conjunctival hyperemia score(p>0.05).Conclusion :The tear film stability of dry eye patients with diabetes is worse than that of dry eye patients without diabetes,and the structure and function of meibomian gland are more damaged,which is related to the duration of diabetes.The decline of tear film stability and meibomian gland dysfunction in diabetes patients can precede dry eye symptoms.There was no significant correlation between Hb A1 c level and ocular surface injury in dry eye patients with diabetes. |
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