Clinical Evaluation of Tear Film in Noninsulin-Dependent Diabetic Patients
Yasmine Maher Mohamed Shaaban;
Abstract
Diabetes can lead to ocular surface impairments with qualitative and quantitative tear disorders. These abnormalities, even if not currently mentioned by diabetic patients, can result in severe complications.
• Our findings support the impression that diabetic patients have an elevated prevalence of dry eye syndrome. Diabetes and dry eyes appear to have a common association.
• In this study, NIDDM patients and control subjects were compared for corneal sensitivity, tear function parameters (Schirmer tests I, II, tear film break-up time (BUT), fluorescein and Lissamine green staining of the anterior surface of the eye, and LIPCOF grading.
• We also investigated systemic factors, such as age, sex, duration of diabetes, metabolic control (GHb), and diabetic peripheral neuropathy in relation to the ocular surface disorders.
• Patient age, sex, and duration of diabetes were not significantly correlated with the corneal sensitivity, tear film and ocular surface changes parameters.
• Poor metabolic control and presence of diabetic neuropathy were significantly correlated with the changes in corneal sensitivity and tear film parameters.
• Corneal sensitivity, Schirmer’s I, II, tear film (BUT) values were clinically diminished in the NIDDM patients compared to the control group but this was not statistically significant.
• Lissamine green staining was high in the NIDDM patients compared to the control group, this was highly statistically significant.
• LIPCOF grading was high in the NIDDM patients compared to the control group, this was highly statistically significant.
• Lissamine green staining and LIPCOF grading was also increased if diabetes is associated with peripheral diabetic neuropathy or poorly controlled.
• Corneal sensitivity diminished in the NIDDM patients if associated with peripheral diabetic neuropathy (highly statistically significant).
• Corneal sensitivity diminished in the poorly controlled NIDDM patients.
• Schirmer’s I, II, tear film BUT diminished in the NIDDM patients if association with poorly controlled diabetes (statistically significant) and diminished also in those with peripheral diabetic neuropathy.
• Decreased corneal sensation is more associated with peripheral diabetic neuropathy, while decreased Schirmer and BUT values are associated with bad control of diabetes
• Schirmer’s and tear film BUT tests were poor in sensitivity. We got different results performing the same test one hour apart or on the second day on the same patients. Schirmer test I values were very low (2 - 5 mm) in 12% of the normal eyes. This is far less than the normal expected value of 10 or more.
• Our findings support the impression that diabetic patients have an elevated prevalence of dry eye syndrome. Diabetes and dry eyes appear to have a common association.
• In this study, NIDDM patients and control subjects were compared for corneal sensitivity, tear function parameters (Schirmer tests I, II, tear film break-up time (BUT), fluorescein and Lissamine green staining of the anterior surface of the eye, and LIPCOF grading.
• We also investigated systemic factors, such as age, sex, duration of diabetes, metabolic control (GHb), and diabetic peripheral neuropathy in relation to the ocular surface disorders.
• Patient age, sex, and duration of diabetes were not significantly correlated with the corneal sensitivity, tear film and ocular surface changes parameters.
• Poor metabolic control and presence of diabetic neuropathy were significantly correlated with the changes in corneal sensitivity and tear film parameters.
• Corneal sensitivity, Schirmer’s I, II, tear film (BUT) values were clinically diminished in the NIDDM patients compared to the control group but this was not statistically significant.
• Lissamine green staining was high in the NIDDM patients compared to the control group, this was highly statistically significant.
• LIPCOF grading was high in the NIDDM patients compared to the control group, this was highly statistically significant.
• Lissamine green staining and LIPCOF grading was also increased if diabetes is associated with peripheral diabetic neuropathy or poorly controlled.
• Corneal sensitivity diminished in the NIDDM patients if associated with peripheral diabetic neuropathy (highly statistically significant).
• Corneal sensitivity diminished in the poorly controlled NIDDM patients.
• Schirmer’s I, II, tear film BUT diminished in the NIDDM patients if association with poorly controlled diabetes (statistically significant) and diminished also in those with peripheral diabetic neuropathy.
• Decreased corneal sensation is more associated with peripheral diabetic neuropathy, while decreased Schirmer and BUT values are associated with bad control of diabetes
• Schirmer’s and tear film BUT tests were poor in sensitivity. We got different results performing the same test one hour apart or on the second day on the same patients. Schirmer test I values were very low (2 - 5 mm) in 12% of the normal eyes. This is far less than the normal expected value of 10 or more.
Other data
| Title | Clinical Evaluation of Tear Film in Noninsulin-Dependent Diabetic Patients | Other Titles | تقييم اكلينيكى لطبقة دموع العين فى مرضى داء السكرى الغير معتمدين على عقار الإنسولين | Authors | Yasmine Maher Mohamed Shaaban | Issue Date | 2014 |
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