Dry eye syndrome and morphological changes of meibomian glands in type 2 diabetic patients

Purpose: To evaluate the morphological changes of meibomian glands and dry eye syndrome in patients with type II diabetes. Methods: The medical records of 72 diabetic patients referred to the ophthalmology clinic for the evaluation of diabetic retinopathy, who had dry eye symptoms, were retrospectively reviewed. Results: A total of 72 patients, with an age of 56.3 ± 13.3 years, were analyzed. The group with diabetic retinopathy (52 patients) had a significantly lower tear film break-up time (p = 0.046), lower Schirmer’s test value (p = 0.005), and higher percentage of upper (p = 0.036) and lower (p = 0.017) meibomian gland area losses than the group without diabetic retinopathy (20 patients). According to multilinear regression analyses considering sex, age, and diabetes-related characteristics, the Schirmer’s test value was significantly lower with increasing stage of diabetic retinopathy (β = -1.180, p = 0.016). The percentage of upper meibomian gland area loss was significantly increased with increasing age (β = 0.605, p < 0.001), glycosylated hemoglobin (β = 1.881, p = 0.011), and stage of diabetic retinopathy (β = 4.458, p = 0.001). The percentage of lower meibomian gland loss area was significantly increased with increasing age (β = 0.443, p = 0.001) and stage of diabetic retinopathy (β = 4.879, p = 0.001). Conclusions: In patients with type 2 diabetes, the more severe the diabetic retinopathy, the more likely the meibomian gland loss will occur, so careful and appropriate treatment should be conducted.