Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
The Effects of Type 2 Diabetes Mellitus on Meibomian Gland Morphology and Tear Film Parameters: Cross-Sectional Study
Tip 2 Diabetes Mellitusun Meibomian Bez Morfolojisi ve Gözyaşı Filmi Parametreleri Üzerine Etkileri: Kesitsel Araştırma
Selma ÖZBEK UZMANa , Züleyha YALNIZ AKKAYAa , Tülay OMMAb , Alper ŞANLIc , Ayşe TÜFEKÇİ BALIKÇIa , Sevde Nur FIRATb , Ayşe BURCUa
aUniversity of Health Sciences Ankara Training and Research Hospital, Department of Ophthalmology, Ankara, Türkiye
bUniversity of Health Sciences Ankara Training and Research Hospital, Division of Endocrinology and Metabolism, Ankara, Türkiye
cSamsun Vezirköprü State Hospital, Clinic of Ophthalmology, Samsun, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(3):177-83
doi: 10.5336/ophthal.2024-103456
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the meibomian gland (MG) morphology and tear film parameters of patients with Type 2 diabetes mellitus (DM) and to compare them with healthy individuals. Material and Methods: Fifty-four eyes of 27 patients (DM group) with Type 2 DM and 50 eyes of 25 healthy individuals (control group) in terms of Ocular Surface Disease Index (OSDI) score, Schirmer's test, van Bijsterveld score (vBs), non-invasive break-up time (NiBUT) and MG morphologies (by non-contact, non-invasive infrared meibography) were evaluated and analyzed. Results: DM and control groups were similar in terms of mean age (p=0.51) and gender (p=0.78). In DM and control groups, respectively; OSDI; 15.3±3.7-11.9±2.7 (p=0.03), Schirmer; 10.3±3.4-12.5±3.2 mm (p<0.001), first NiBUT; 7.47±4.38- 10.41±4.89 sec (p=0.002), mean NiBUT; 9.6±3.7 vs. 12.3±4.0 sec (p<0.001), meibo-degree; 1.59±1.20-0.82±1.04 units (p<0.001), meibo score 31.3±22.2%-18.5±16.9% (p<0.001) and vBs; were 3.8±2.4 and 2.2±1.7 (p<0.001). In the DM group, a significant relationship was found between the presence of retinopathy and Schirmer (p<0.001), first NiBUT (p<0.001), average NiBUT (p<0.001), meibo score (p<0.001) and vBs (p<0.001). Conclusion: Type 2 DM, negatively affects MG morphology and tear film layer. Evaluation of DM patients in terms of MG dysfunction and dry eye disease as well as retinopathy during routine examinations can ensure early diagnosis of MG dysfunction and dry eye disease, initiation of appropriate treatment and protection of the ocular surface.

Keywords: Meibomian gland dysfunction; meibography; meiboscore; Type 2 diabetes mellitus; dry eye disease
ÖZET
 Amaç: Tip 2 diabetes mellitus (DM) hastalarının meibomian bez (MG) morfolojisi ve gözyaşı filmi parametrelerinin değerlendirilmesi ve sağlıklı bireylerle karşılaştırılması amaçlandı. Gereç ve Yöntemler: Tip 2 DM'li 27 hastanın 54 gözü (DM grubu) ve 25 sağlıklı bireyin 50 gözü (kontrol grubu) çalışmaya alındı. Tüm olguların, Oküler Yüzey Hastalık İndeksi [Ocular Surface Disease Index (OSDI)] skoru, Schirmer testi, van Bijsterveld skoru (vBs), non-invaziv gözyaşı kırılma zamanı [non-invasive break-up time (NiBUT)] ve MG morfolojileri (temassız, non-invaziv kızılötesi meibografi cihazı ile) değerlendirildi ve analiz edildi. Bulgular: DM ve kontrol grubu, yaş ortalaması (p=0,51) ve cinsiyet (p=0,78) açısından benzerdi. DM ve kontrol gruplarında sırasıyla; OSDI; 15,3±3,7-11,9±2,7 (p=0,03), Schirmer; 10,3±3,4-12,5±3,2 mm (p<0,001), ilk NiBUT; 7,47±4,38- 10,41±4,89 sn (p=0,002), ortalama NiBUT; 9,6±3,7-12,3±4,0 sn (p<0,001), meibo-derece; 1,59±1,20-0,82±1,04 birim (p<0,001), meibo skoru %31,3±22,2-%18,5±16,9 (p<0,001) ve vBs; 3,8±2,4 ve 2,2±1,7 (p<0,001) idi. DM grubunda retinopati varlığı ile Schirmer (p<0,001), ilk NiBUT (p<0,001), ortalama NiBUT (p<0,001), meibo skoru (p<0,001) ve vBs (p<0,001) arasında anlamlı ilişki saptandı. Sonuç: Tip 2 DM, MG morfolojisini ve gözyaşı filmi tabakasını olumsuz etkiler. DM hastalarının rutin muayenelerinde retinopati yanı sıra MG disfonksiyonu ve kuru göz hastalığı yönünden de değerlendirmelerinin yapılması, MG disfonksiyonu ve kuru göz hastalığının erken tanısı ile uygun tedavinin başlanmasını ve oküler yüzeyin korunmasını sağlayabilir.

Anahtar Kelimeler: Meibomian bez disfonksiyonu; meibografi; meiboskor; Tip 2 diabetes mellitus; kuru göz hastalığı
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