Meibomian Gland dysfunction and dry eye disease symptoms in patients with type 2 Diabetes Mellitus


  • Т.М. Zhmud National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • N.V. Malachkova National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • O.O. Andrushkova National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • К.Y. Hrizhymalska National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Keywords: diabetes mellitus, meibomian gland dysfunction, dry eye disease, meibography.

Abstract

An important problem to date is the dysfunction of meibomian glands in patients with type 2 diabetes. The aim of our work was to analyze the prevalence of meibomian gland dysfunction and signs of dry eye disease in patients with type 2 diabetes. We examined 40 patients (80 eyes) with compensated type 2 diabetes mellitus and symptoms of dry eye disease, who made up the main group at the age of 54.00±8.00 years, and 30 patients (60 eyes) of practically healthy people, aged 51.00±8.00 years. All patients underwent visiometry, biomicroscopy, ophthalmoscopy, tonometry, compression test to evaluate the secretion of meibomian glands, Schirmer’s test for compression before and after 30 min. Afterwards, Norn test, meibography, Demodex mite test, laboratory tests (lipidogram, blood glucose, glycosylated hemoglobin). In addition, standard OSDI, McMonnies Dry Eye Questionnaire questionnaires were used and an average clipping rate of1 min was determined. Statistical processing of the obtained results was carried out using the license package “Statistica 8.0” using parametric estimation methods. Our study has shown that in patients with diabetes for more than 5 years, dry eye disease occurs more often and is dominated by moderate and severe severity. Each patient in the study group, together with the symptoms of dry eye, had signs of dysfunction of the meibomian glands of varying degrees of severity according to the compression test and objective symptoms of the disease. A significant difference was found between the clipping frequency in the control group and the main one (p≤0.01). Compared with the control group, patients with diabetes have a longer interval between the clipping movements. Meibography data show that patients in the primary group have changes in the meibomian glands in 90% of cases, while in the control group – 44%. Thus, it was found that patients with type 2 diabetes had dysfunction of meibomian glands of moderate severity in 90% of cases, which is associated with the duration of diabetes.

References

[1] Arita, R., Suehiro, J., Haraguchi, T., Shirakawa, R., Tokoro, H., & Amano, S. (2014). Objective image analysis of the meibomian gland area. British Journal of Ophthalmology, 98(6), 746-755. doi: 10.1136/bjophthalmol-2012-303014

[2] Craig, J. P., Nelson, J. D., Azar, D. T., Belmonte, C., Bron, A. J., Chauhan, S. K., ... Nichols, J. J. (2017). TFOS DEWS II report executive summary. The Ocular Surface, 15(4), 802-812. doi: 10.1016/j.jtos.2017.08.003

[3] Figueroa-Ortiz, L. C., Rodríguez, E. J., García-Ben, A., & García-Campos, J. (2011). Study of tear function and the conjunctival surface in diabetic patients. Archivos de la Sociedad Española de Oftalmología (English Edition), 86(4), 107-112. doi: 10.1016/s2173-5794(11)70020-2

[4] Gökçe, C., Aycan-Kaya, Ö., Yula, E., Üstün, İ., Yengil, E., Sefil, F., ... Bayram, F. (2013). The effect of blood glucose regulation on the presence of opportunistic Demodex folliculorum mites in patients with type 2 diabetes mellitus. Journal of International Medical Research, 41(5), 1752-1758. doi: 10.1177/0300060513494730

[5] Gökçe, C., Aycan-Kaya, Ö., Yula, E., Üstün, İ., Yengil, E., Sefil, F. ... Bayram, F. (2013). The effect of blood glucose regulation on the presence of opportunistic Demodex folliculorum mites in patients with type 2 diabetes mellitus. Journal of International Medical Research, 41(5), 1752-1758. doi: 10.1177/0300060513494730

[6] Kashnykova, O. A., Maichuk, D. Yu., & Polunyn, G. S. (2004). Use of soft contact lenses in patients with symptomatic dry eyes. Refractive surgery, 4(1), 52-58.

[7] Kurt, R. K., Kaya, O. A., Karateke, A., Silfeler, D. B., Karapınar, O. S., Akkoca, A. N., & Hakverdi, A. U. (2014). Increased density of Demodex folliculorum mites in pregnancies with gestational diabetes. Medical Principles and Practice, 23(4), 369-372. doi: 10.1159/000363244

[8] Manaviat, M. R., Rashidi, M., Afkhami-Ardekani, M., & Shoja, M. R. (2008). Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmology, 8(1), 10. doi: 10.1186/1471-2415-8-10

[9] Najafi, L., Malek, M., Valojerdi, A. E., Khamseh, M. E., & Aghaei, H. (2015). Dry eye disease in type 2 diabetes mellitus; comparison of the tear osmolarity test with other common diagnostic tests: a diagnostic accuracy study using STARD standard. Journal of Diabetes & Metabolic Disorders, 14(1), 39. doi: 10.1186/s40200-015-0157-y

[10] Nakonechnyi, D. O., & Bezkorovaina, I. M. (2015). Control of the course of the “dry eye” syndrome in patients with diabetes mellitus by the method of tear crystallography when using a combined preparation based on trehalose and hyaluronate sodium. Topical Problems of Modern Medicine: Bulletin of the Ukrainian Medical Dental Academy, 1, 5(4(52)), 194-199.

[11] Németh, J., Fodor, E., Lang, Z., Kosina-Hagyó, K., Berta, A., Komár, T. ... Kemer, O. E. (2012). Lid-parallel conjunctival folds (LIPCOF) and dry eye: a multicentre study. British journal of ophthalmology, 96(11), 1380-1385. doi: 10.1136/bjophthalmol-2012-301580

[12] Nichols, K. K., Foulks, G. N., Bron, A. J., Glasgow, B. J., Dogru, M., Tsubota, K. ... Sullivan, D. A. (2011). The international workshop on meibomian gland dysfunction: executive summary. Investigative Оphthalmology & Visual Science, 52(4), 1922-1929. doi: https://doi.org/10.1167/iovs.10-6997a

[13] Pathan, R. (2015). Prevalence of meibomian gland disease in type II diabetic patients & its clinical presentations. J. Evid. Based. Med., 2(4), 346-353. doi: 10.18410/jebmh/51

[14] Qiao, J., & Yan, X. (2013). Emerging treatment options for meibomian gland dysfunction. Clinical ophthalmology (Auckland, NZ), 7, 1797-1803. doi: 10.2147/OPTH.S33182

[15] Rapuano, C. J. (2008). American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern Guidelines. Conjunctivitis.

[16] Shamsheer, R. P., & Arunachalam, C. (2015). A clinical study of meibomian gland dysfunction in patients with diabetes. Middle East African Journal of Ophthalmology, 22(4), 462-466. doi: 10.4103/0974-9233.167827

[17] Stapleton, F., & Carnt, N. (2012). Contact lens-related microbial keratitis: how have epidemiology and genetics helped us with pathogenesis and prophylaxis. Eye, 26(2),185-193. doi: 10.1038/eye.2011.288

[18] Sullivan, B. D., Evans, J. E., Krenzer, K. L., Reza Dana, M., & Sullivan, D. A. (2000). Impact of antiandrogen treatment on the fatty acid profile of neutral lipids in human meibomian gland secretions. The Journal of Clinical Endocrinology & Metabolism, 85(12), 4866-4873. doi: https://doi.org/10.1210/jcem.85.12.7066

[19] Tomlinson, A., Bron, A. J., Korb, D. R., Amano, S., Paugh, J. R., Pearce, E. I., ... & Dogru, M. (2011). The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Investigative ophthalmology & visual science, 52(4), 2006-2049. doi: 10.1167/iovs.10-6997f

[20] Wise, R. J., Sobel, R. K., & Allen, R. C. (2012). Meibography: A review of techniques and technologies. Saudi Journal of Ophthalmology, 26(4), 349-356. doi: 10.1016/j.sjopt.2012.08.007

[21] Zabehailo, A. O., Safonova, T. N., & Makarov, I. A. (2013). A new way to determine the severity of the blepharoconjunctival form of “dry eye” syndrome. Cataract and Refractive Surgery,13(1), 35-38.

[22] Zhmud, T. M., & Drozhzhina, G. I. (2019). Meibomian gland dysfunction accompanied by palpebral demodicosis in patients with type 2 diabetes mellitus. Journal of Ophthalmology, 6(491), 23-28. doi.org/10.31288/oftalmolzh201962328

[23] Zhmud, T. M., Nikolaichuk, D. V., & Nikolaichuk, V. I. (2018). Improvement of the technique of non-contact portable meibography. Oftalmologiia. Eastern Europe., 8(4), 488-496.
Published
2019-12-19
How to Cite
ZhmudТ., Malachkova, N., Andrushkova, O., & HrizhymalskaК. (2019). Meibomian Gland dysfunction and dry eye disease symptoms in patients with type 2 Diabetes Mellitus. Reports of Morphology, 25(4), 51-55. https://doi.org/https://doi.org/10.31393/morphology-journal-2019-25(4)-08