Tear Film Changes in Type II Diabetes Mellitus with and without Diabetic Retinopathy

Abstract

Introduction: With the substantial progress in understanding of the ocular surface system in the past decade, Dry Eye Disease (DED) is the more commonly encountered condition in diabetes. Diabetes and DED have a common association. Aim: To estimate the prevalence of dry eye in diabetic patient and tear film changes with Diabetic Retinopathy (DR). Materials and Methods: It was an observational cross-sectional study, in which 103 type II diabetic patients attending the Department of Ophthalmology in a Tertiary Care Hospital were enrolled, out of which 43 patients had DR and 60 patients had no DR. Dry eye evaluation was done using Ocular Surface Disease Indexing (OSDI) questionnaire and was confirmed objectively using Schirmer’s I and II test and Tear film Break Up Time (TBUT). Statistical Package for the Social Sciences (SPSS) version 20 was used for statistical analysis of this study data. All quantitative data were analysed by using parametric test whereas all qualitative data were analysed by using non-parametric test to find significance level and the p-value <0.05 was considered significant. Results: In present study, 68 among 103 diabetics patients had DED with the prevalence of 66% based on OSDI scoring. Out of the 43 patients with DR and 60 without DR, DED was encountered in 38 and 30 patients, respectively. DED status was not influenced by gender, age and duration of diabetes. An increase in DED was seen with higher HbA1c (Glycated Haemoglobin) values but was not significant. DED in DR group yielded a significant association with OSDI (p=0.002), Schirmer’s I and II (p=0.001) and TBUT (p=0.046). Conclusion: On the basis of present study, it can be stated that the prevalence of dry eye was more in DR patients in comparison to those without retinopathy. Therefore, all diabetic patients should be screened for dry eye, in order to diagnose and treat it at the earliest.