Assessment of the Tear Meniscus Using Optical Coherence Tomography in Patients With Type 2 Diabetes Mellitus.
OBJECTIVE
To analyze tear meniscus dimensions with Fourier domain-optical coherence tomography (FD-OCT) in patients with type 2 diabetes mellitus.


METHODS
Patients with type 2 diabetes without diabetic retinopathy (DR) (n = 54), with nonproliferative DR (n = 45), with proliferative DR (PDR) (n = 25), and controls (n = 45) were enrolled. Hemoglobin A1c and Early Treatment Diabetic Retinopathy Study (ETDRS) stages of DR were evaluated. Schirmer test (ST), tear breakup time test, and fluorescein corneal staining were carried out. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were obtained by FD-OCT.


RESULTS
TMH, TMD, and TMA in the diabetes and control groups were 233 ± 79 μm, 148 ± 53 μm, and 0.026 ± 0.015 mm, and 261 ± 67 μm, 167 ± 49 μm, and 0.032 ± 0.017 mm, respectively. All parameters were lower in diabetes (all P < 0.01). And the values in PDR were 185 ± 90 μm, 117 ± 50 μm, and 0.017 ± 0.010 mm which were lower than those in control and nonproliferative DR (227 ± 71 μm, 144 ± 50 μm, and 0.023 ± 0.010 mm) (all P < 0.01). TMH, TMD, and TMA correlated with ST (P < 0.01, P = 0.02, and P < 0.01, respectively) and the corneal staining score (all P < 0.01). Patients with longer diabetes duration and a history of panretinal photocoagulation showed significantly decreased TMH, TMD, and TMA (P < 0.01).


CONCLUSIONS
OCT, along with tear breakup time and ST, is an effective way to assess tear function in type 2 diabetes. Patients with PDR and a history of panretinal photocoagulation showed lower tear meniscus parameters. The decrease in tear meniscus parameters was correlated with diabetes duration.
*Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; and †Department of Ophthalmology and Visual Science, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Jiwon
J
Baek
Sang Hee
SH
Doh
Sung Kun
SK
Chung
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D015352:Dry Eye Syndromes / Q000503:physiopathology*; D005260:Female; D005583:Fourier Analysis; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D013666:Tears / Q000737:chemistry / Q000502:physiology*; D041623:Tomography, Optical Coherence
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human