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The association between diabetes (DM) and herpes simplex eye disease (HSED)

Poster Details

First Author: M.Kosker TURKEY

Co Author(s):    K. M. Hammersmith   P. K. Nagra   A. H Nassef   C. J. Rapuano     

Abstract Details

Purpose:

Aim of the study was to examine whether there is an association between DM and HSED, (1) by comparing the prevalence of type 1 and type 2 DM in patients with HSED and control patients without HSED, (2) examining whether presence of DM is associated with the severity of ocular surface HSED as measured by visual acuity between ocular surface HSED patients with DM and control HSED patients without DM and (3) examining whether the severity of DM as measured by regulation type of DM is associated with the severity of ocular surface HSED in diabetic ocular surface HSED patients.

Setting:

Cornea Service of the Wills Eye Hospital, Philadelphia, PA

Methods:

We conducted 3 substudies. Study 1 included 541 patients with HSED and 3226 controls. Study 2 involved 40 diabetic and 120 non-diabetic ocular surface HSED patients. Severity of ocular surface HSED was graded as mild, moderate or severe based on best-corrected visual acuity. Patients were excluded if they had fewer than 2 office visits or had non-herpes simplex related vision-threatening conditions. Study 3 included 40 diabetic ocular surface HSED patients in Study 2. Diabetes was graded as; diet group (DM controlled with diet), oral group (DM controlled with oral medications) and insulin group (DM control required insulin).

Results:

Five of 541 (0.93%) HSED patients had type 1 DM, similar to 19/3246 (0.59%) controls (p=0.375). Forty-eight of 541 (8.88%) HSED patients had type 2 DM, similar to 287/3246 (8.84%) controls (p=0.981). Using multinomial logistic regression analyses, the probability/risk of being in the severe ocular surface HSED group as opposed to the mild ocular surface HSED group were not statistically significantly different between DM patients and those without DM (p=0.120; OR=1.900; 95%CI=0.846-4.266). There was no association between severity of DM as measured by the type of DM regulation and severity of HSED (Spearman’s rank correlation test; r=-0.081, p=0.619).

Conclusions:

Although various disturbances in humoral innate immunity have been described in diabetic patients, the clinical relevance of DM and HSED is not clear. We did not find any association between ocular HSED and diabetes. Because retrospective studies have limitations, a prospective study with a better classification of diabetes according to glycosylated hemoglobin levels and with a better classification of HSED using the number of recurrent HSED is needed to further understand the association between HSED and diabetes. As a result, there may not be a positive association between type 2 DM and HSED.

Financial Disclosure:

NONE

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