He Fanglin, Zhao Zhanlin, Liu Yan, Lu Linna, Fu Yao
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai, China.
J Ophthalmol. 2018 Jul 15;2018:1206808. doi: 10.1155/2018/1206808. eCollection 2018.
To investigate the impact of disease duration on the ocular surface during the course of type 2 diabetes mellitus compared with nondiabetic controls.
One hundred twenty diabetic patients were divided into three groups according to disease duration: less than 5 years, 5-10 years, and over 10 years. All eyes were imaged using a corneal topographer (Oculus Keratograph 5M). Tear film measurements and meibography were also recorded. Meibomian gland changes were scored from 0 to 6 (meiboscore).
The noninvasive breakup time first (NIKBUT-1st) and noninvasive breakup time average (NIKBUT-avg) were significantly shorter in the over 10 years diabetic group compared with the control group (=0.0056 and =0.010, resp.). Tear meniscus height (TMH) was significantly lower in the over 10 years diabetic group compared with the control group (=0.0016) and the 5 years group (=0.0061). We also found that more patients in the over 10 years diabetic group showed bulbar and limbal hyperemia compared with the control group (bulbar hyperemia: =0.049; limbal hyperemia: =0.026). The meiboscore in the over 10 years diabetic group was significantly higher compared with the other three groups ( < 0.05). Bulbar hyperemia showed a significant negative correlation with NIKBUT-1st in the over 10 years diabetic group (=-0.35 and < 0.05).
Ocular surface damage in long-term type 2 diabetes is more severe than that in patients with shorter disease duration.
与非糖尿病对照组相比，研究2型糖尿病病程中疾病持续时间对眼表的影响。
120例糖尿病患者根据病程分为三组：病程小于5年、5至10年、超过10年。所有眼睛均使用角膜地形图仪（Oculus Keratograph 5M）进行成像。还记录了泪膜测量和睑板腺造影。睑板腺变化从0到6分进行评分（睑板腺评分）。
与对照组相比，病程超过10年的糖尿病组首次无创泪膜破裂时间（NIKBUT-1st）和平均无创泪膜破裂时间（NIKBUT-avg）显著缩短（分别为=0.0056和=0.010）。与对照组（=0.0016）和病程5年组（=0.0061）相比，病程超过10年的糖尿病组泪河高度（TMH）显著降低。我们还发现，与对照组相比，病程超过10年的糖尿病组中更多患者出现球结膜和角膜缘充血（球结膜充血：=0.049；角膜缘充血：=0.026）。病程超过10年的糖尿病组睑板腺评分显著高于其他三组（<0.05）。在病程超过10年的糖尿病组中，球结膜充血与NIKBUT-1st呈显著负相关（=-0.35，<0.05）。
长期2型糖尿病患者的眼表损伤比病程较短的患者更严重。
