title: Peripheral neuropathy and tear film dysfunction in type 1 diabetes mellitus.
abstract: OBJECTIVE
  To compare tear film metrics in patients with type 1 diabetes mellitus (DM) and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality.
  
  
  METHODS
  Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment.
  
  
  RESULTS
  Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P = 0.12 and P = 0.33, resp.). Tear lipid thickness (P = 0.02), stability (P < 0.0001), and quantity (P = 0.01) were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P < 0.001) and tear film stability was inversely associated with total neuropathy score (r = -0.29, P = 0.03).
  
  
  CONCLUSIONS
  The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Stuti L
authors.initials: SL
authors.lastname: Misra
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Dipika V
authors.initials: DV
authors.lastname: Patel
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Charles N J
authors.initials: CN
authors.lastname: McGhee
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Monika
authors.initials: M
authors.lastname: Pradhan
authors.affiliation: Department of Neurology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Dean
authors.initials: D
authors.lastname: Kilfoyle
authors.affiliation: Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Geoffrey D
authors.initials: GD
authors.lastname: Braatvedt
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Craig
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*