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Graefe's Archive for Clinical and Experimental Ophthalmology

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27-08-2022 | Xerophthalmia | Cornea

Evaluation and comparison of subjective and objective anterior ocular surface damage in patients with type 2 diabetes mellitus and dry eye disease

Authors: Tetiana Zhmud, Galyna Drozhzhyna, Nataliia Malachkova

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 2/2023

Abstract

Purpose

To evaluate anterior ocular surface damage in patients with type 2 diabetes mellitus and dry eye disease in comparison to non-diabetic controls based on conjunctival impression cytology, objective scales (Efron, Oxford) and OSDI, to correlate vision-related quality of life with grades of squamous metaplasia in T2DM patients suffering from DED.

Methods

All participants underwent complete ophthalmologic examination including Shirmer test, TBUT, conjunctival/corneal staining (Oxford scheme), evaluation of conjunctival redness (Efron grading scale), and conjunctival impression cytology (Nelson’s scale). The OSDI questionnaire was completed by both groups of patients to assess severity of DED and QoL.

Results

Squamous metaplasia was observed in 94% of the study group and 19.3% of controls (p = 0.0000). Based on the OSDI scores, 73.5% of patients reported mild DED and 26.5% suffered from moderate DED in the study group. The mean OSDI score for the study group with Nelson’s grade 2 was 18 ± 3.52 and 20.8 ± 4.68 for Nelson’s grade 3, respectively (p = 0.0745). Hence, no significant difference in QoL between grade 2 and grade 3 of squamous metaplasia was observed in patients of the study group.

Conclusion

Impression cytology is a reliable minimally invasive tool for an accurate evaluation of the ocular surface damage in patients with DED and type 2 diabetes mellitus. Severe squamous metaplasia (Nelson’s grade 3) was observed in 29.4% (10/34) of T2DM patients. In contrast, it was not detected in the control group (p = 0.0032). The absence of goblet cells in T2DM patients nether significantly reduces QoL nor contributes to the subjective DED severity (OSDI) due to complex pathways leading to DED. Thus, diagnosis of DED severity should not be solely based on subjective symptoms in this population.

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Title: Evaluation and comparison of subjective and objective anterior ocular surface damage in patients with type 2 diabetes mellitus and dry eye disease
Authors: Tetiana Zhmud
Galyna Drozhzhyna
Nataliia Malachkova
Publication date: 27-08-2022
Publisher: Springer Berlin Heidelberg
Keywords: Xerophthalmia
Diabetes
Type 2 Diabetes
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 2/2023
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-022-05806-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation and comparison of subjective and objective anterior ocular surface damage in patients with type 2 diabetes mellitus and dry eye disease

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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