Conjunctival impression cytology and tear film changes in patients with type 2 diabetes mellitus and its correlation with severity of diabetic retinopathy.

PURPOSE

Dry eye symptoms can substantially affect the quality of life and visual outcome. There are several studies on ocular surface changes reported in diabetic patients. There is limited literature defining the relationship between dry eye with diabetic retinopathy (DR). The study aimed to find out the correlation of dry eye with the severity of DR.

METHODS

In a cross-sectional observational study, we recorded the grading of dry eye in patients with DR on Schirmer's, tear film breakup time (TBUT), and impression cytology. We correlated the severity of dry eye with the severity of retinopathy using Spearman's correlation and Kruskal-Wallis test. We also found a significant correlation between glycemic control and the severity of dry eye. < 0.05 was considered statistically significant.

RESULTS

One hundred and eighty-four eyes of 96 patients with DR were assessed. One hundred and fifty-eight eyes with nonproliferative DR and thirty-four eyes with proliferative DR were included in the study. Mean Schirmer's and TBUT values were 15.4 ± 5.8 mm and 10.1 ± 2.8 s, respectively. Average impression cytology grade on Modified Nelson's grading was found to be Grade 3. A positive correlation was found between the severity of dry eye with the severity of DR on Schirmer's, TBUT, and impression cytology.

CONCLUSION

Diabetics with severe grades of retinopathy had poor tear function along with compared to those with milder grades of DR. Hence, routine screening of the ocular surface should become a part of diabetic eye evaluation.