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Diabetic Dry eye disease and its relevance with severity of diabetic retinopathy

Diabetic Dry eye disease and its relevance with severity of diabetic retinopathy. (FP-58, E-Poster Serial No. 158, AIOC-2011, Ahmedabad). Chief & Presenting Author DR. GAUTAM KUMAR KUKADIA (K12525). Co-authors: Dr. Rashmita Kukadia (K12535) Dr. Rupam Desai (D08414)

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Diabetic Dry eye disease and its relevance with severity of diabetic retinopathy

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  1. Diabetic Dry eye disease and its relevance with severity of diabetic retinopathy (FP-58, E-Poster Serial No. 158, AIOC-2011, Ahmedabad) Chief & Presenting Author DR. GAUTAM KUMAR KUKADIA (K12525) Co-authors: Dr. Rashmita Kukadia (K12535) Dr. Rupam Desai (D08414) Dr. Falguni Mehta (M08814)Dr. O. P. Billore (B02055)

  2. Introduction • Diabetes is far more dangerous then anticipated mainly due to relatively late manifestations and which might be without clear cut signs and symptoms. • It is imperative to have a high index of suspicion and planning of regular follow up to detect changes like diabetic dry eye disease, at earlier stage. • This study addresses the importance of simple Schirmer test analysis to identify and to forestall the retinopathy development among diabetics at earlier stage to prevent further ocular damage.

  3. PURPOSE • To study the incidence of dry eye among, • Patients with diabetes. • Various age groups of diabetic patients. • Various sub-groups of diabetic retinopathy

  4. STUDY DESIGN • A prospective randomized case-control study of 500 patients (250 diabetics and 250 controls). Patients examined for incidence of dry eye with Schirmer test with comparison of data among diabetics. • All diabetic patients were compared with nondiabetic controls for Schirmer test analysis results.

  5. MATERIAL & METHODS • All patients were grouped as • Age groups: from 30 to 89 years • Status of retinopathy • No retinopathy • Background retinopathy • Proliferative retinopathy • The age groups formed were as 30-39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years and 80-89 years

  6. Results • The study results were analyzed as follows, • Results of Schirmer test analysis among diabetics compared to controls • Results of Schirmer test analysis among diabetics at various stages of retinopathy.

  7. Schirmer test analysis in diabetics & controls • Mean Schirmer test reading in diabetics was 17.92±8.38 mm to 23.96±2.06 mm in control group. • Age wise groups in diabetics show Schirmer test 21.22 to 24.63, 20.43 to 23.98, 16.73 to 15.44, 17.56 to 23.88, 18.51 to 23.77 and 17.38 to 24.13 in groups 30-39, 40-49, 50-59, 60-69, 70-79 and 80-89 years respectively.

  8. Schirmer test: Stages of diabetic retinopathy • The mean Schirmer test reading was 18.43±8.87, 16.58±6.99, 13.3±5.8 in diabetics with no retinopathy, background retinopathy and proliferative retinopathy.

  9. Schirmer’s test in various age groups • The Schirmer’s test analysis showed that dry eye was more common in age group 30-39 years with mean reading 21.22 mm in diabetics vs. 24.63mm in controls (p=0.064), 20.43 mm vs. 23.98 mm in group 40-49 years group (p=0.079), 16.73 mm vs. 15.44 mm in 50-59 years group (p=0.13), 17.56 mm vs. 23.88 mm in group 60-69 years (p=0.002), 18.51mm vs. 23.77mm in group 70-79 years (p=0.02) and 17.38 mm vs. 24.13 mm in group 80-89 years (p=0.0003) in diabetics and controls respectively. • This study suggests that diabetic dry eye is more common at higher age group patients.

  10. (…Discussion continued )Schirmer test at various stages of diabetic retinopathy • The mean Schirmer test reading was 18.43±8.87, 16.58±6.99, 13.3±5.8 in diabetics with no retinopathy, background retinopathy and proliferative retinopathy. • The difference was statistically significant for nonretinopathy and background retinopathy (p=0.044), background to proliferative retinopathy (p=0.0001), and for patients without retinopathy and patients with proliferative retinopathy (p=0.00035). • It could be suggested that those diabetics progressing to development of retinopathy could be observed with more dry eye. • Development of proliferative changes are highly associated with more severe dry eye conditions.

  11. Conclusion • Dry eye is much more common among diabetics than in normal population. • Higher age groups are comparatively more susceptible to development of dry eye disease among diabetics. • Diabetic dry eye disease worsens faster with the development of proliferative changes in retina. • It is possible to check progression of diabetic dry eye disease by simple means of Schirmer test analysis on regular intervals.

  12. Thank You...

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