Akinci A, Cetinkaya E, Aycan Z
Department of Pediatric Ophthalmology, Diskapi Children Hospital, Ankara, Turkey.
Eur J Ophthalmol. 2007 Nov-Dec;17(6):873-8. doi: 10.1177/112067210701700601.
To compare the symptoms, signs, and results of objective tests for dry eye syndrome (DES) in type 1 diabetes mellitus (T1DM) patients and controls.
A total of 104 children with T1DM and 104 age- and sex-matched controls were compared in terms of the symptoms, signs, and results of objective tests for DES. Duration of T1DM, presence of diabetic retinopathy, mean hemoglobin A1c level, pubertal status, and a history of accompanying autoimmune disease were noted in T1DM group. Analysis of variance, multivariate regression analysis, Student t, Mann-Whitney U, and chi-square tests were used for statistical analysis.
A total of 15.4% of diabetic children complained of dry eye symptoms, versus 1.9% of the controls (p=0.029). Dry eye signs were detected in 7.7% of diabetic children, versus 0.96% of controls (p=0.034). Tear break-up time (TBUT) and Schirmer test results were significantly lower in T1DM group than controls (p=0.018, p=0.024, respectively). A total of 7.7% of diabetic children had definite and 0.96% had probable diagnosis of DES, versus none of the controls (p=0.03). TBUT and Schirmer test results were significantly lower in patients with more than 10 years duration of T1DM (p<0.001 for both).
The prevalence of symptoms, signs, and definite diagnosis of DES are higher and basal tear secretion and tear film stability are lower in diabetic children than controls. Duration of T1DM is the only disease-related variable which is associated with basal tear secretion and tear film stability.
比较1型糖尿病(T1DM)患者和对照组干眼综合征(DES)的症状、体征及客观检查结果。
对104例T1DM患儿和104例年龄及性别匹配的对照组进行DES症状、体征及客观检查结果的比较。记录T1DM组的T1DM病程、糖尿病视网膜病变情况、平均糖化血红蛋白水平、青春期状态及自身免疫性疾病伴随史。采用方差分析、多因素回归分析、Student t检验、Mann-Whitney U检验和卡方检验进行统计学分析。
共有15.4%的糖尿病患儿主诉有干眼症状,而对照组为1.9%(p = 0.029)。7.7%的糖尿病患儿检测到干眼体征,而对照组为0.96%(p = 0.034)。T1DM组的泪膜破裂时间(TBUT)和泪液分泌试验结果显著低于对照组(分别为p = 0.018,p = 0.024)。共有7.7%的糖尿病患儿确诊为DES,0.96%可能诊断为DES,而对照组均无(p = 0.03)。T1DM病程超过10年的患者TBUT和泪液分泌试验结果显著更低(两者均p < 0.001)。
糖尿病患儿DES的症状、体征及确诊率高于对照组,基础泪液分泌和泪膜稳定性低于对照组。T1DM病程是唯一与基础泪液分泌和泪膜稳定性相关的疾病相关变量。