Maryam Ferdousi1, Ioannis N Petropoulos2, Alise Kalteniece1, Shazli Azmi1, Georgios Ponirakis2, Nathan Efron3, Handrean Soran1, Rayaz Ahmed Malik1,2. 1. Institute of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester and NIHR/Wellcome Trust Clinical Research Facility, Manchester, United Kingdom. 2. Weill Cornell Medicine-Qatar, Research Division, Qatar Foundation, Education City, Doha, Qatar. 3. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Abstract
Purpose: Patients with diabetes have a propensity to develop dry eye symptoms (DES), with reduced tear secretion and corneal sensitivity. The underlying pathologic basis of DES was explored in patients with Type 1 diabetes. Methods: Forty-two patients with Type 1 diabetes mellitus (T1DM) (age: 49.21 ± 2.53 years, duration of diabetes: 29.98 ± 2.64 years) and 25 control subjects (age: 48.70 ± 2.84 years) underwent assessment of DES using a validated dry eye questionnaire, and tear stability and tear production were assessed using tear breakup time (TBUT) and Schirmer's test, respectively. Corneal confocal microscopy was undertaken to quantify corneal nerve fiber density (CNFD), branch density (CNBD), fiber length (CNFL), keratocyte density (KD), and corneal epithelial basal cell (CEBC) density and area. Results: The prevalence of DES was significantly higher (P = 0.03), and TBUT (P = 0.006), corneal sensation (P < 0.0001), CNFD (P = 0.001), CNBD (P = 0.001), CNFL (P = 0.003), and KD (P = 0.04) were significantly lower in patients with T1DM compared to control subjects. However, these measures did not differ significantly between T1DM patients with and without dry eye. There was no correlation between DES and TBUT or corneal nerve keratocyte and CEBC morphology. Conclusions: DES and TBUT are significantly increased in patients with T1DM, but are not related to corneal nerve, basal epithelial, or keratocyte cell morphology.
Purpose: Patients with diabetes have a propensity to develop dry eye symptoms (DES), with reduced tear secretion and corneal sensitivity. The underlying pathologic basis of DES was explored in patients with Type 1 diabetes. Methods: Forty-two patients with Type 1 diabetes mellitus (T1DM) (age: 49.21 ± 2.53 years, duration of diabetes: 29.98 ± 2.64 years) and 25 control subjects (age: 48.70 ± 2.84 years) underwent assessment of DES using a validated dry eye questionnaire, and tear stability and tear production were assessed using tear breakup time (TBUT) and Schirmer's test, respectively. Corneal confocal microscopy was undertaken to quantify corneal nerve fiber density (CNFD), branch density (CNBD), fiber length (CNFL), keratocyte density (KD), and corneal epithelial basal cell (CEBC) density and area. Results: The prevalence of DES was significantly higher (P = 0.03), and TBUT (P = 0.006), corneal sensation (P < 0.0001), CNFD (P = 0.001), CNBD (P = 0.001), CNFL (P = 0.003), and KD (P = 0.04) were significantly lower in patients with T1DM compared to control subjects. However, these measures did not differ significantly between T1DM patients with and without dry eye. There was no correlation between DES and TBUT or corneal nerve keratocyte and CEBC morphology. Conclusions: DES and TBUT are significantly increased in patients with T1DM, but are not related to corneal nerve, basal epithelial, or keratocyte cell morphology.
Authors: Hoda Gad; Bara Al-Jarrah; Saras Saraswathi; Ioannis N Petropoulos; Georgios Ponirakis; Adnan Khan; Parul Singh; Souhaila Al Khodor; Mamoun Elawad; Wesam Almasri; Hatim Abdelrahman; Ahmed Elawwa; Amel Khalifa; Ahmed Shamekh; Fawziya Al-Khalaf; Goran Petrovski; Mahmoud Al Zyoud; Maryam Al Maadheed; Mohamed A Hendaus; Khalid Hussain; Anthony K Akobeng; Rayaz A Malik Journal: J Diabetes Investig Date: 2020-07-07 Impact factor: 4.232