Tear Film Dysfunction a Marker of Diabetic Neuropathy

Megan Brooks

November 07, 2013

Tear film dysfunction, which is often seen in adults with type 1 diabetes, correlates with peripheral neuropathy, a new study shows.

"Ocular surface assessment, including corneal in vivo confocal microscopy and tear film analysis, has the potential to predict diabetic peripheral neuropathy," said lead investigator Stuti Misra, a postdoctoral corneal research fellow from the University of Auckland in Grafton, New Zealand.

Misra presented the findings at the American Academy of Optometry 2013 Annual Meeting in Seattle.

"Many patients with diabetes show signs of compromised ocular surface, but limited research has been done on tear film dysfunction in these patients," she said.

Misra and her team assessed the association between tear film parameters in patients with type 1 diabetes and peripheral neuropathy.

The study involved 53 patients with type 1 diabetes and a mean age of 49 years, and 40 healthy control subjects with a mean age of 44 years.

 
Detailed ocular surface assessments, including corneal confocal microscopy and tear film analysis, are not a standard procedure in patients with diabetes.
 

There was no significant difference in dry eye symptom scores between the diabetic and control groups (P = .33). However, tear lipid thickness was lower in the diabetic than in the control group (P = .02), as were tear film stability (P < .0001) and tear production (P = .01).

There was a positive correlation between tear film stability and corneal sub-basal nerve density (P = .04), and an inverse correlation between tear film stability and total neuropathy score (P = .03). Decreased tear film stability was associated with increasing age (P = .05) and duration of diabetes (P = .03).

"Our diabetic group exhibited significantly poorer tear film stability, secretion, and lipid layer grades than the control group," Misra reported. "A correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy."

Another of the study investigators, Charles McGhee, PhD, from the University of Auckland, noted that "currently, detailed ocular surface assessments, including corneal confocal microscopy and tear film analysis, are not a standard procedure in patients with diabetes."

However, "these detailed but time-consuming ocular surface tests can add significant information and could become an important part of diabetes assessment when these techniques become faster and more automated," Dr. McGhee noted.

This study was supported by the Save Sight Society of New Zealand Incorporated and the New Zealand Optometric Vision Research Foundation. The authors have disclosed no relevant financial relationships.

American Academy of Optometry 2013 Annual Meeting: Abstract 130219. Presented October 24, 2013.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....