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First Author: FaniAkritidou GREECE
Co Author(s): Maria Karafyloglou Dimitrios Mpakas Vlasios Antoniou Vasilios Kolokoutsas Damianos Mposvelis Dimitrios Karamanis
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This study was performed to assess the prevalence of dry eye syndrome and to study the tear film function of patients with type 2 diabetes.
: General Hospital of Kavala – Greece
In this study 93 people (59 ♀ and 34 ♂), aged 48 to 91 years old, with type 2 diabetes were enrolled. All of the participants were receiving antidiabetic treatment (tablets or insulin) for at least 10 consecutive years. Tear film function was evaluated by tear breaking up time (BUT) and Schirmer test. The OSDI questionnaire was used in order to measure dry eye disease (normal, mild to moderate and severe) and to evaluate the effect on vision-related function.
Of 93 subjects, 49 patients (52.6%) suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. Tear film function was reduced in diabetic population. A BUT value lower than 10sec was found in 92.4% of diabetics (mean BUT value 6.8 ± 3.7 sec) and 26% of these patients had tear secretion, measured by Schirmer test, lower than 10mm (mean Schirmer value 9 ±6.5 mm) Mean OSDI questionnaire score was detected as 37.12 ± 19.05 (range 4–75). Although the clinical presentation of DES in diabetes mellitus is very heterogeneous and can be already present at an early stage of diabetes mellitus, clinical studies reveal that poorly controlled diabetes mellitus increases the frequency and DES severity in the long term. This disease seems to be more severe in patients with advanced stages of diabetic retinopathy.
In this study the prevalence of dry eye syndrome was 52.6% among patients with diabetes mellitus, type 2. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. Clinical and experimental evidence indicates that diabetes mellitus causes of DES are multifactorial. There are several theories that might explain the connection between dry eye and diabetes. The most frequently cited associated factors include peripheral neuropathy secondary to hyperglycemia, insulin insufficiency and inflammation. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease. The high frequency of diabetes mellitus in the population and DES in diabetic patients indicates that it is relevant to test for diabetes mellitus, in DES patients, in case of any clinical suspicion. The OSDI questionnaire, used together with the BUT and Schirmer test, is easily performed and may be of benefit in supporting the diagnosis of dry-eye syndrome. FINANCIAL INTEREST: NONE