Abstract
Purpose
To investigate the relationship between the duration of type 2 diabetes mellitus (DM)
and the ocular surface, and to address the question of why some people with lengthy
DM duration are asymptomatic, whereas some people with shorter DM duration have pain
or discomfort in their eyes.
Methods
Eighty-seven eyes of 87 subjects with different durations of DM and 49 eyes of 49
subjects without DM underwent Schirmer I test, tear film break-up time, sodium fluorescein
staining and tear meniscus height (TMH) measurement, and completed the Standardized
Patient Evaluation of Eye Dryness (SPEED) questionnaire. Corneal structure and function
were assessed with in vivo confocal corneal microscopy and with a corneal sensitivity
esthesiometer. Both corneal nerve fiber length and inferior whorl length (IWL) were
assessed as indices for neural structure. Age and gender were matched between groups.
HbA1c levels >7.8% and proliferative diabetic retinopathy were exclusion criteria.
Results
In the DM group, compared with the non-DM group, the SPEED score was significantly
higher (p = 0.013), and corneal sensitivity and IWL were lower (p < 0.001). Schirmer I test, corneal sensitivity and IWL differed significantly between
the group with DM duration >10 years and the non-DM (control) group (p = 0.021, p < 0.001, p < 0.001, respectively). Schirmer I test and IWL were significantly lower in the group
with DM >10 years than in the group with DM ≤10 years (p = 0.023, p < 0.001, respectively). Corneal sensitivity was positively correlated with IWL regardless
of diabetes status.
Conclusions
The lower SPEED score and asymptomatic feeling in people with a longer DM duration
may be explained by the decreased IWL and reduced sensitivity.
Keywords
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Article info
Publication history
Published online: April 24, 2019
Accepted:
February 19,
2019
Received in revised form:
January 9,
2019
Received:
July 5,
2018
Identification
Copyright
© 2019 Published by Elsevier Ltd on behalf of British Contact Lens Association.
