| Objective:Objective To investigate the changes of ocular surface characteristics in patients with type 2 diabetes mellitus complicated with diabetic peripheral neuropathy（DPN）.Objective To investigate the stability of tear film,tear content and ocular surface health status of DPN patients.Methods:A total of 92 patients（92 eyes）with type 2 diabetes admitted to the Department of Endocrinology,the First Hospital of Shanxi Medical University from November 2021 to November 2022 were collected and divided into 35 patients（35 eyes）in DPN group and57 patients（57 eyes）in T2DM group according to whether they had diabetic peripheral neuropathy.At the same time,41 patients（41 eyes）who had no complaints of eye discomfort during the same period were collected as the control group.（1）Glycosylated hemoglobin A1c(Hb A1c)and diabetes duration between DPN patients and T2DM patients,and the differences in age and gender of all subjects were recorded and compared.（2）All subjects filled in the Ocular Surface Disease Score Index（OSDI）questionnaire,recorded the scores,and compared the score differences among the three groups.Collect eye-related indicators:The anterior segment was examined by slit lamp microscopy,and the data of lacrimal river height（TMH）,first tear film rupture time（NITBUTf）,and mean tear film rupture time（NITBUTav）were collected by Keratograph5M ocular surface comprehensive analyzer.Meanwhile,the relevant indexes of ocular surface,such as lipid layer,conjunctival congestion degree,and blepharomial gland loss degree,were analyzed.Finally,to compare whether there were differences in ocular surface indexes among DPN group,T2DM group and control group.（3）The different ocular surface indexes were used as independent variables,and the correlation analysis between ocular surface indexes and OSID score was performed among the three groups.Results:1.There was no significant difference in the duration of diabetes between the DPN group and the T2DM group（P>0.05）.Comparison of age and gender between the three groups,P>0.05,the difference is not statistically significant,the groups are comparable.2.There were significant differences in OSDI score,TMH,NIBUTf,NIBUTav,lipid layer analysis,conjunctival hyperemia and meibomian gland loss between DPN group,T2DM group and control group（P<0.05）.The comparison of TMH between DPN group and T2DM group showed statistically significant（P<0.05）.OSDI score and ocular surface indexes were compared between DPN group and control group,P<0.05,and the difference was statistically significant.The OSDI scores and ocular surface indexes were compared between the T2DM group and the control group,P<0.05,and the difference was statistically significant.3.In the DPN group,OSID score was positively correlated with TMH（r=0.355,P<0.05）,but was not significantly correlated with NITBUTf,NITBUTav,lipid layer thickness,eye color and meibomian gland loss（P>0.05）.There was no significant correlation between OSDI score and ocular surface index in T2DM group and control group（P>0.05）.Conclusion:The DPN group had higher OSDI scores,lower tear river heights,shorter tear film rupture times,lower lipid layer scores and more severe lid gland deficiency.The tear river height was lower in the DPN group compared to the T2DM group.This indicates that patients with DPN have an uneven distribution of the lipid layer,low tear content and poor tear film stability. |
