J Korean Ophthalmol Soc.  2019 Nov;60(11):1037-1042. 10.3341/jkos.2019.60.11.1037.

Dry Eye Syndrome and Morphological Changes of Meibomian Glands in Type 2 Diabetic Patients

• Kwak JY
• Choi KR
• Han KE
• Jun RM

• KMID: 2463353
• DOI: http://doi.org/10.3341/jkos.2019.60.11.1037

Abstract

PURPOSE
To evaluate the morphological changes of meibomian glands and dry eye syndrome in patients with type II diabetes.
METHODS
The medical records of 72 diabetic patients referred to the ophthalmology clinic for the evaluation of diabetic retinopathy, who had dry eye symptoms, were retrospectively reviewed.
RESULTS
A total of 72 patients, with an age of 56.3 ± 13.3 years, were analyzed. The group with diabetic retinopathy (52 patients) had a significantly lower tear film break-up time (p = 0.046), lower Schirmer's test value (p = 0.005), and higher percentage of upper (p = 0.036) and lower (p = 0.017) meibomian gland area losses than the group without diabetic retinopathy (20 patients). According to multilinear regression analyses considering sex, age, and diabetes-related characteristics, the Schirmer's test value was significantly lower with increasing stage of diabetic retinopathy (β = −1.180, p = 0.016). The percentage of upper meibomian gland area loss was significantly increased with increasing age (β = 0.605, p < 0.001), glycosylated hemoglobin (β = 1.881, p = 0.011), and stage of diabetic retinopathy (β = 4.458, p = 0.001). The percentage of lower meibomian gland loss area was significantly increased with increasing age (β = 0.443, p = 0.001) and stage of diabetic retinopathy (β = 4.879, p = 0.001).
CONCLUSIONS
In patients with type 2 diabetes, the more severe the diabetic retinopathy, the more likely the meibomian gland loss will occur, so careful and appropriate treatment should be conducted.

Keyword

Diabetic retinopathy; Dry eye syndrome; Meibomian gland

MeSH Terms

Diabetic Retinopathy
Dry Eye Syndromes*
Hemoglobin A, Glycosylated
Humans
Medical Records
Meibomian Glands*
Ophthalmology
Retrospective Studies
Tears

Figure

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  Figure 1 Method of calculating total meibomian gland area and meibomian gland loss area using Image J® (NIH, Bethesda, MD, USA). Whitish area represents the meibomian gland. The ratio of meibomian gland loss area (%) = (meibomian gland loss area/total meibomian gland area) × 100. (A) Total meibomian gland area of the lower lid, (B) meibomian gland loss area of the lower eyelid in the same patient.

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