Yu Tao, Shi Wei-Yun, Song Ai-Ping, Gao Yang, Dang Guang-Fu, Ding Gang
Qingdao University, Qingdao 266071, Shandong Province, China; Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China.
Shandong Eye Hospital, Shandong Eye Institute, Jinan 250021, Shandong Province, China.
Int J Ophthalmol. 2016 Dec 18;9(12):1740-1744. doi: 10.18240/ijo.2016.12.06. eCollection 2016.
To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus (DM).
Of 118 eyes (118 patients) with type 2 DM (DM group) and 100 eyes of 100 control subjects (control group) were enrolled. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NI-BUT) and the structure of the meibomian glands (MGs, meibography) were assessed by the Keratograph 5M system. Partial or complete loss of MG was scored for each eyelid from grade 0 (no loss) to grade 3 (lost area was >2/3 of the total MG area), which were also examined by laser scanning confocal microscopy (LSCM). The primary outcomes were meibomian gland acinar unit density (MGAUD), meibomian gland acinar longest diameter (MGALD) and meibomian gland acinar shortest diameter (MGASD).
Compared with control group, the OSDI was significantly higher in DM group (=-5.916; <0.001), while the NI-BUT was significantly lower (=-7.765; <0.001). Keratograph showed that there were more MGs dropout in DM group than that in control group. The meiboscore was significantly higher in DM group compared with control group (=-3.937; <0.001). LSCM revealed that there were cytological alterations of MGs in DM group compared with control group, which included enlargement of MG acinar units and decreased in density of MG acinar units. Specifically, there were lower MGAUD, larger MGALD and MGASD in DM group than control group (=-10.120, -9.4442, -7.771; <0.001).
Compared with the normal control participants, the patients with type 2 DM had more unstable tear films and severe symptoms of dry eye. Using Keratograph 5M system and LSCM, we found that the patients with type 2 DM had more significant morphological and cytological changes and dysfunction in MGs.
研究2型糖尿病（DM）患者睑板腺的形态学变化。
纳入118例2型糖尿病患者的118只眼（DM组）和100例对照者的100只眼（对照组）。完成眼表疾病指数（OSDI）问卷后，使用角膜地形图仪5M系统评估无创泪膜破裂时间（NI-BUT）和睑板腺（MGs，睑板腺造影）结构。对每个眼睑的MG部分或完全缺失进行评分，从0级（无缺失）到3级（缺失面积>MG总面积的2/3），同时通过激光扫描共聚焦显微镜（LSCM）进行检查。主要观察指标为睑板腺腺泡单位密度（MGAUD）、睑板腺腺泡最长直径（MGALD）和睑板腺腺泡最短直径（MGASD）。
与对照组相比，DM组的OSDI显著更高（=-5.916；<0.001），而NI-BUT显著更低（=-7.765；<0.001）。角膜地形图显示，DM组的MG缺失比对照组更多。DM组的睑板腺评分显著高于对照组（=-3.937；<0.001）。LSCM显示，与对照组相比，DM组的MG存在细胞学改变，包括MG腺泡单位增大和MG腺泡单位密度降低。具体而言，DM组的MGAUD低于对照组，MGALD和MGASD大于对照组（=-10.120，-9.4442，-7.771；<0.001）。
与正常对照者相比，2型糖尿病患者的泪膜更不稳定，干眼症状更严重。使用角膜地形图仪5M系统和LSCM，我们发现2型糖尿病患者的MG存在更显著的形态学和细胞学变化及功能障碍。
