Clinical Characteristic Of Ocular Surface Damage In Type 2 Diabetes Mellitus Patients

Objective: To observe the clinical characteristics of ocular surface damage in type 2diabetes mellitus patients,and to explore its correlation with the duration of diabetes and diabetic retinopathy.Methods: Choose outpatients with 2 type diabetes from August 2015 to December2015 who were visited to Department of Ophthalmology, in the First Hospital of Jilin University, a total of 83 cases(166 eyes), male 40 cases 80 eyes(48.2%), female 43 cases86 eyes(51.8%), aged 33-77 years old, mean age 55.87±9.89 years old, and were grouped according to the duration of diabetes and diabetic retinopathy; patients without diabetes were collected at the same time age and gender matched, a total of 40 cases(80 eyes), male 19 cases 38 eyes(47.5%), female 21 cases 42 eyes(52.5%), aged 32-77 years old, mean age55.75±11.28 years old. All patients were carried out non invasive break-up time(BUT),meibomian gland morphology, corneal and conjunctival staining, Schirmer test(Schirmer I),corneal confocal microscope examination. The results were analyzed and processed by SPSS18.0.Result: Dry eye prevalence rate of Diabetes was 95.2%, higher than 87.5% in the control group, the difference was statistically significant(P<0.05). The diabetic group compared with the control group: The results of the average break-up time was 7.18[5.00,9.52] seconds, was lower than 9.02[ 5.16,12.8]seconds in the control group(P< 0.05);The results of the Schirmer I was 5.50[5.00,10.25]mm, was lower than 8.50 [5.00,15.5]mm in the control group(P<0.05); The positive rate of corneal fluorescein staining was 15.1%,was higher than 12.5% in the control group(P>0.05); The positive rate of conjunctival lissamine green staining was 98.2%, was higher than 90% in the control group(P<0.05); Thescore of conjunctival lissamine green staining was 4[3,6], was higher than 3[2,5] in the control group(P<0.05); The score of Oxford ocular was 5[3,6], was higher than 3.5[2,6] in the control group(P<0.05);The abnormality rate of the meibomian gland was 31.9%,was higher than 17.5% in the control group(P<0.05); The number of subbasal corneal nerve fiber was 2.64 [2.00,3.33] branch/picture, was lower than 3.23[2.00, 4.00]branch/picture in the control group(P<0.05); The length of subbasal corneal nerve fiber was 478.09 [351.28,608.47]um/picture, was lower than 645.70[463.53,888.94]um/picture in the control group(P< 0.05).The average break-up time, the abnormality meibomian gland grading, subbasal corneal nerve fiber number and length were related with duration of diabetes and diabetic retinopathy(P < 0.05).Conclusion: Compared with nondiabetic patients, Diabetes patients with shorter BUT,tear film instability have shorter Schirmer test results, more severe conjunctiva、meibomain glands and corneal nerve damage. In addition, the stability of the tear film, meibomian gland and corneal nerve damage was related with the duration of diabetes and diabetic retinopathy.