| BackgroundDry eye is a multifactorial disease characterized by eye discomfort,visual impairment,decreased tear film stability,increased tear osmotic pressure and ocular surface inflammation,affecting patients,quality of life and visual quality and resxulting in a huge economic burden.Diabetic mellitus is considered to be one of the risk factors of dry eye.The pathogenesis of diabetes-related dry eye is still unclear.Demodex can cause inflammation and damage in ocular surface tissues such as gingival margin,meibomian gland and conjunctiva through direct destruction,physical damage,immune response and other mechanisms,which may be related to dry eye.The incidence of dry eye and Demodex in diabetic patients is higher than that in non-diabetic patients,indicating that there may be some correlation between them.Demodex may play a role in the development of diabetes-related dry eye.Therefore,we aim to investigate the effect of Demodex on the ocular surface function in patients with diabetic by analyzing dry eye index,meibomian gland loss,and eye aphid symptoms between Demodex-positive group and Demodex?negative group.Method86 diabetic patients and age-and sex-matched non-diabetic patients were enrolled in the ophthalmology clinic of Zhujiang Hospital of Southern Medical University from April 2018 to September 2018.The patients were conducted a series of tests for Ocular Surface Disease Index(OSDI)5 Schirmer I test(SIT),tear film break-up time(BUT),corneal fluorescence staining(FL),tear height,superior meibomian gland loss score,inferior meibomian gland loss score,total meibomian gland loss score,and demodex counts.The incidence of dry eye and the positive rate of Demodex was calculated and its influencing factors were also analyzed.Moreover,the effects of Demodex on dry eye index,meibomian gland loss and eye aphid symptoms were also analyzed in patients with type 2 diabetes mellitus.Result1.The incidence of dry eye(68.60%vs 39.53%)and Demodex(70.93%vs 46.51%),OSDI,and demodex countswere higher and BUT was shorter in patients with type 2 diabetes than that in non-diabetic patients(P<0.05).There was no significant difference in other related parameters of dry eye and meibomian gland loss between the two groups(P>0.05).2.There were no significant corrections between the incidence of dry eye or the positive rate of demodex with gender,age,duration of diabetes,blood glucose level,DR5 or insulin usage(P>0.05).Theinferior meibomian gland loss scorewas higher in male patients with type 2 diabetes than that in female(P<0.05).There were no significant differences in other dry eye index,meibomian gland loss score and demodex count between different genders(P>0.05).The differences in eye index,meibomian gland lossscore,and demodex count were not significant(P>0.05).And there were significant differences of demodex counts,BUT,superior meibomian gland loss score,inferior meibomian gland loss score,and superior and inferior meibomian glands in different disease groups.(P<0.05),while the differences of other dry eye indexes were not statistically significant(P>0.05).The FL score and demodex counts of poor glycemic control group were higher than those with good glycemic control(P<0.05).The remaining dry eye index,meibomian gland loss score,and Demodex count were not statistically significant(P>0.05).there were no significant differences in the dry eye index,meibomian gland loss score,and Demodex count between insulin usage group and non-insulin usage group(P<0.05).The OSDI score of the DR group was higher than that of the non-DR group(P<0.05),however,there were no significant differences in meibomian gland loss score,creep and the Demodex count(P>0.05).3.In type 2 diabetic patients,BUT in Demodex-positlve group was significant shorter than that in Demodex-negative group and showed negatively correlated with Demodexcount(r=0.73,P<0.001).Demodex count showed mild to moderate correlations with eyelid symptom score,itching and redness(r=0.34,P=0.001;r=0.258,P?0.002;r=0.258,P?0.017),While there were no significant correlation between demodex count and other parameters(P>0.05).Conclusion1.The incidence of dry eye in patients with type 2 diabetes was high,and symptoms of dry eye were more severe than in non-diabetic patients,indicating diabetes may be involved in the pathogenesis of dry eye.2.The incidence of dry eye and the positive rate of Demodex in patients with type 2 diabetes were not related to gender,age,duration,glycemic level,DR status,or insulin usage.3.Increased demodex counts in patients with type 2 diabetes were associated with decreased BUT and increased demodex induced eye symptoms,suggesting demodex may play a role in the development of diabetes-related dry eye. |
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