Diabetes mellitus is associated with dry eye syndrome: a meta-analysis

Yoo, Tae Keun; Oh, Ein

doi:10.1007/s10792-019-01110-y

Cited by 61 publications

(49 citation statements)

References 58 publications

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“…23 This is due, in part, to a reduction in the corneal subbasal nerve plexus and disruption of the lacrimal function unit. [23][24][25][26][27][28] This is further supported by studies showing a significant reduction in tear production in patients with T2DM. [29][30][31] More recent evidence now suggests that T2DM may be a causative factor in meibomian gland disease (MGD).…”

Section: Introductionmentioning

confidence: 60%

The Association Between Risk Factors for Metabolic Syndrome and Meibomian Gland Disease in a Dry Eye Cohort

Mussi¹,

Haque²,

Robertson³

2021

OPTH

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Purpose: Risk factors for metabolic syndrome include abdominal obesity, insulin resistance, hypertension, high triglycerides and/or low high-density lipoprotein cholesterol, and hyperglycemia. Risk factors for metabolic syndrome have been associated with dry eye disease; however, their association with meibomian gland disease (MGD), a subtype of dry eye, is unclear. In the present study, we investigated risk factors for metabolic syndrome in a dry eye cohort with and without MGD. Methods: This retrospective case-control study evaluated electronic medical records at a major urban outpatient medical center to identify patients with a known diagnosis of dry eye disease with and without MGD. Males and females were matched for age, smoking status, race, ethnicity, and body mass index (BMI). Patient demographics, anthropometric measurements, medical history, clinical findings, and serologies were analyzed. A diagnosis of MGD was based on clinical signs noted in the medical record. Results: MGD was not associated with BMI, smoking, type 2 diabetes mellitus, hypertension or hyperlipidemia in this dry eye cohort. MGD was associated with male sex and increasing age. While increasing age was weakly correlated with decreased low density lipoprotein cholesterol and non-high density lipoprotein cholesterol, serum lipid levels were not associated with MGD. Conclusion: Importantly, we found that risk factors for metabolic syndrome are not specifically associated with an increase in MGD when compared to non-MGD dry eye subjects. While risk factors for metabolic syndrome are associated with dry eye disease, they likely reflect a chronic systemic state of low-grade inflammation that negatively impacts the function of both lacrimal and meibomian glands.

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Section: Introductionmentioning

confidence: 60%

The Association Between Risk Factors for Metabolic Syndrome and Meibomian Gland Disease in a Dry Eye Cohort

Mussi¹,

Haque²,

Robertson³

2021

OPTH

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“…Частота встречаемости гипертонической болезни и диабета среди вошедших в исследование пациентов (51,8 и 16,6%) существенно превысила среднепопуляционный уровень [17][18][19][20][21][22], составляющий 30-47% и 3% соответственно [23,24], и практически совпала с литературными данными -от 47,5 до 48,8% и от 15,9 до 29,4% соответственно [25][26][27]. Как следствие, системная фармакологи-ческая нагрузка у обследованных нами больных оказалась достоверно выше, чем у людей того же возраста, не страдавших глаукомой.…”

Section: Discussionunclassified

Realization of a cascade treatment algorithm for glaucoma in St. Petersburg

Аntonova¹,

Nikolaenko²,

Brzheskiy³

2021

Russian Journal of Clinical Ophthalmology

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Aim: to analyze the duration and regimen of topical treatment and the pattern of prior laser and surgical procedures in patients with glaucoma who were admitted to the hospital for IOP-lowering interventions. Patients and Methods: this study included 500 consecutively enrolled patients who underwent surgery for uncontrolled glaucoma in 2016– 2020 and were followed up for 6–24 months. Disease history, cumulative "preservative" load, clinical examinations, and surgical outcomes were assessed. Results: preoperatively, most patients received the maximum medical therapy (i.e., three agents in two bottles). Simultaneous use of all four major classes of IOP-lowering medications occurred in 10% of patients only. Two-third of patients required surgical interventions to reduce IOP after a 6-year medical therapy. By the time of admission, 60% of patients were diagnosed with advanced or end-stage glaucoma. Prior laser or surgical procedures to reduce IOP were performed only in 142 patients and 52 patients, respectively. Treatment adherence was lower in men compared to women, irrespective of its stage. Conclusion: most patients received adequate medical therapy. However, in general, surgery was performed too late. It gives the impression that the efficacy of therapeutic and laser stages of cascade glaucoma treatment is no more than five years. In addition to the obvious drawbacks of a laissez-faire strategy (irreversible vision loss), the risk of surgical failure significantly increases. Long-term (at least 3-year) therapy using (non)fixed-dose combinations of agents containing preservatives is the major modifiable risk factor for early filtration loss. Preservativefree prostaglandin analogues improve treatment tolerability, adherence to treatment, and chances for success of IOP-lowering surgery. The authors’ results demonstrate that gender differences should be considered when planning treatment and follow-up visits. Keywords: glaucoma, IOP-lowering therapy, glaucoma surgery, ocular surface, preservatives, benzalkonium chloride. For citation: Antonova A.V., Nikolaenko V.P., Brzheskiy V.V. Realization of a cascade treatment algorithm for glaucoma in St. Petersburg. Russian Journal of Clinical Ophthalmology. 2021;21(3):123–128 (in Russ.). DOI: 10.32364/2311-7729-2021-21-3-123-128.

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“…Publication bias was assessed with funnel plots, Begg's test (rank correlation method) and Egger's test (linear regression method) ( 33 ). Meta-regression was used to examine the differences between studies in terms of such possibly influential factors as preoperative MGD status, DM status ( 21 , 22 ), the corresponding preoperative DED-related parameters, the size of incision ( 9 , 23 ), and the country of origin. Subgroup analyses were performed based on the following meta-regression results: preoperative MGD status (cataract patients with various degrees of preoperative MGD and studies with unspecified preoperative MGD status); DM status (a specified proportion of cataract patients diagnosed with DM, cataract patients without DM or systemic disease, and studies with unspecified DM status).…”

Section: Methodsmentioning

confidence: 99%

“…To understand better whether phacoemulsification cataract surgery induces or aggravates postoperative dry eye, we undertook a systematic review and meta-analysis of the published literature on DED-relevant parameters, including questionnaires on subjective symptoms, tear break-up time (BUT), corneal fluorescein staining (CFS), and the Schirmer I test. We paid special attention to potential DED-influencing factors, such as pre-existing MGD ( 7 ), diabetes mellitus (DM) ( 21 , 22 ), the preoperative status of the ocular surface, the incision size ( 9 , 23 ), and the country of origin.…”

Section: Introductionmentioning

confidence: 99%

Dry Eye and Phacoemulsification Cataract Surgery: A Systematic Review and Meta-Analysis

Lü

Zhu

2021

Front. Med.

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Purpose: To evaluate whether dry eye deteriorates after phacoemulsification cataract surgery, and to explore the influential factors.Methods: Studies published before February 2020 indexed on PubMed and the Cochrane Central Register of Controlled Trials were retrieved. A meta-analysis, including meta-regression, a sensitivity analysis, and a subgroup analysis, were performed.Results: Twenty studies with 2,247 eyes were included in the meta-analysis, dry eye-related parameters were investigated preoperatively and 1 month postoperatively. Patients with pre-existing meibomian gland dysfunction (MGD) had worsened subjective symptoms of dry eye (1.31, 95% confidence interval (CI) [0.66, 1.95], P < 0.0001), a reduced tear break-up time (BUT) (−2.27, 95% CI [−2.66, −1.88], P < 0.0001), and a worse corneal fluorescein staining (CFS) score (0.75, 95% CI [0.5, 1.0], P < 0.0001) after phacoemulsification cataract surgery, whereas in the general population, the subjective symptoms score and CFS remained unchanged and BUT decreased slightly after surgery. Patients without diabetes showed significantly reduced total tear secretion after phacoemulsification cataract surgery (−1.25, 95% CI [−1.62, −0.88], P < 0.0001).Conclusion: Dry eye generally remained unchanged 1 month after phacoemulsification cataract surgery. Notably, worsened symptoms and signs of dry eye were observed more frequently in patients with pre-existing MGD. Patients without diabetes were more susceptible to reduced tearing postoperatively.Clinical Trial Registration: Identifier: PERSPERO (2020: CRD42020203316).

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Diabetes mellitus is associated with dry eye syndrome: a meta-analysis

Cited by 61 publications

References 58 publications

The Association Between Risk Factors for Metabolic Syndrome and Meibomian Gland Disease in a Dry Eye Cohort

The Association Between Risk Factors for Metabolic Syndrome and Meibomian Gland Disease in a Dry Eye Cohort

Realization of a cascade treatment algorithm for glaucoma in St. Petersburg

Dry Eye and Phacoemulsification Cataract Surgery: A Systematic Review and Meta-Analysis

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