A Case-control Study Of Corneal Characteristics And Dry Eye Disease In Children With Diabetes

Purpose: To compare the prevalence of dry eye disease,corneal characteristics and related visual function between children and adolescents with diabetes and healthy people of same age,and to explore the unique factors of dry eye disease in these diabetic patients.Methods: Case-control study.From 2018 to 2019,children and adolescents with diabetes were selected as the case group,while healthy children and adolescents were selected as the control group.The prevalence of dry eye disease,corneal topography,central corneal thickness and wavefront abberation were analyzed.The related factors of dry eye disease,corneal characteristics and wavefront abberation were also analyzed in the case group.In addition,we collected dry eye diseases cases with diabetic patients and corresponding healthy control without dry eye disease: a)adults without diabetes;b)children without diabetes and c)patients with diabetes.There were total 6 groups with 10 cases in each group.After completing lacrimal secretion test,we collected the lacrimal secretion filter paper,extracted the protein,labelled it with tandem mass tags,and then analyzed the samples by using liquid chromatography-electrospray ionization-mass spectrometry.Further bioinformatics analysis was carried out to obtain differential protein and enrichment pathway among groups.Results: The prevalence of dry eye disease in case group was significantly higher than that in control group.Multivariate logistic regression analysis showed that only the duration of diabetes and corneal perception were independent factors.Among corneal characteristics,significant difference only happens in central corneal thickness between the two groups,and it was not related to other clinical factors.The mean value of total and higher-order aberrations in the case group was slightly higher than that in the control group,and there was no statistical difference.At the same time,it was found that the root mean square value of aberrations was related to the anterior and posterior surface curvature of the lens.Six common differential proteins,including complement,immune and lipid metabolism related proteins,were obtained from the intersection of differential proteins of diabetes related dry eye disease in adult and children groups.Enrichment analysis showed that the common pathway of adult group and children group was complement pathway,while the different enrichment pathways were focal adhesion,amoebiasis and gap junction.Conclusions: We should strengthen the early screening and diagnosis of dry eye disease and keratopathy in children and adolescents with diabetes,especially for those with long duration of diabetes,peripheral neuropathy and abnormal enrichment pathway.