| Objective:To analyze and compare the differences in ocular surface parameters between type 2 diabetes mellitus and non-diabetic patients by Lipiview eye surface interferometer,and to explore the ocular surface damage and early diagnosis and treatment of type 2 diabetes mellitus.Methods:From September 2018 to December 2019,we selected 85 patients with type 2 diabetes treated in the Department of Endocrinology and Ophthalmology of the Affiliated Hospital of Guizhou Medical University and to recruit 39 non-diabetic patients at the same time.Type 2 diabetic patients were divided into groups according to the duration and the degree of ocular surface symptoms.All patients were examined by basic information collection,ocular surface disease index scale(OSDI),lacrimal lipid layer thickness(LLT),partial blink rate(PB),meibomian gland photography,tear secretion test I(SIt),slit lamp anterior segment examination,tear film break-up time(TBUT)and corneal fluorescein staining.SPSS22.0 software is used for statistical analysis of the obtained data.The measurement data obey the normal distribution were expressed in the form of (?)±s.Those that do not obey normal distribution were expressed in the form of M(Q25?Q75).Two groups of measurement data which are in accordance with normal distribution used T tests,but used rank sum test for which do not obey normal distribution.Multiple groups of measurement data which obey normal distribution and have homogeneity of variance used analysis of variance,or used Kruskal-Wallis H tests.The counting data is expressed by frequency or rate,compare with chi-square tests;correlation was analyzed by Pearson correlation method(when obeying a normal distribution)or Spearman correlation method(when a normal distribution is not satisfied).When p<0.05,It was statistically significant.Results:(1)Compared with the non-diabetic group,OSDI,meibomian gland loss score and the positive rate of corneal fluorescein staining of type 2 diabetic group were significantly higher(p<0.05);LLT,SIt and TBUT of type 2 diabetic group were significantly decreased(p<0.001);there was no significant difference in PB in both groups(Z=0.733,p=0.463).(2)Pairwise comparison showed that with the prolongation of type 2diabetes,the OSDI and meibomian gland loss score increased,SIt and TBUT decreased;and the LLT of type 2 diabetes showed a downward trend with the prolongation of the disease,and the ocular surface parameters among different course groups were statistically significant(p<0.05);there was no significant difference in PB among different course groups(H=2.327,p=0.312);the positive rate of corneal fluorescein staining increased gradually with the prolongation of type 2 diabetes,whereas there was no statistically significant difference among different course groups(?~2=2.354,p=0.308).(3)With the aggravation of ocular surface symptoms,the OSDI of type 2 diabetes increased,SIt and TBUT decreased,and there were significant differences among different symptom degree groups(p<0.05);the LLT of type 2 diabetes also decreased and among different symptom degree groups the difference was also statistically significant(p<0.05).(4)The lacrimal lipid layer thickness and the degree of symptoms in type 2 diabetic group were negatively correlated and the correlation was statistically significant(OS r=-0.743 p<0.001,OD r=-0.761 p<0.001).(5)The lacrimal lipid layer thickness and the duration in type 2diabetic group were negatively correlated and the correlation was statistically significant(OS r=-0.613 p<0.001,OD r=-0.704 p<0.001).(6)There was a negative correlation between the lacrimal lipid layer thickness and partial blink rate in type 2diabetic group and the correlation was statistically significant(r=-0.169,p<0.05).Conclusion:Type 2 diabetic patients are more likely to have discomfort ocular surface symptoms,accompanied by decreased stability of tear film,decreased tear secretion and abnormal meibomian gland,so we should put more attention to the ocular surface examination during the course of type 2 diabetes mellitus.The changes of lacrimal lipid layer thickness in type 2 diabetic patients are closely related to the severity of ocular surface symptoms and the duration of the disease.Lipiview eye surface interferometer can be used in the study of diabetic ocular surface status,and the role of blinking training should not be ignored in the diagnosis and treatment of diabetic ocular surface damage. |
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