title: Ocular Surface Characteristics in Diabetic Children.
abstract: To compare tear film osmolarity (TFO) and other dry eye tests between diabetic children and normal healthy children.
  
  
  
  Twenty-six diabetic children (Group 1) and 20 healthy children without any ocular and/or systemic disorder (Group 2) were enrolled in the study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, TFO measurement (Tear Lab Osmolarity System, San Diago, CA, USA), corneal epithelial thickness (CET) measurement using the anterior segment optical coherence tomography (OCT) (RTVue CAM, Optovue Inc, CA, USA), tear film break-up time (TFBUT) test, Schirmer test, meibography, and conjunctival brush cytology were performed. The results were compared between the groups.
  
  
  
  The mean TFO was significantly higher in Group 1 (328.8 ± 12.8) than Group 2 (313.6 ± 15.1) (p = 0.001). The mean Schirmer test score was significantly lower in Group 1 (16.7 ± 5.1) than Group 2 (23.6 ± 5.6) (p = 0.00). Cytologic analysis revealed grade 0 changes in 11 patients (42.3%), grade 1 changes in 13 patients (50%), and grade 2 changes in 2 patients (7.7%) in Group 1 whereas grade 0 changes in 18 patients (90%) and grade 1 changes in 2 patients (10%) were observed in Group 2 (p = 0.004). The TFO levels were significantly associated with HbA1c levels (r = 0.459, p = 0.018).
  
  
  
  The study revealed significantly higher TFO, lower Schirmer test scores and changes in conjunctival cytology in diabetic children. Altered ocular surface changes in diabetic children may be due to the result of increased TFO.
authors.affiliation: a Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital , Department of Ophthalmology , Istanbul , Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Gunay
authors.affiliation: a Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital , Department of Ophthalmology , Istanbul , Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Celik
authors.affiliation: b Haydarpasa Numune Training and Research Hospital , Department of Ophthalmology , Istanbul , Turkey.
authors.forename: Elvin
authors.initials: E
authors.lastname: Yildiz
authors.affiliation: b Haydarpasa Numune Training and Research Hospital , Department of Ophthalmology , Istanbul , Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Bardak
authors.affiliation: c Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital , Department of Pathology , Istanbul , Turkey.
authors.forename: Nermin
authors.initials: N
authors.lastname: Koc
authors.affiliation: d Umraniye Training and Research Hospital , Department of Pediatric Endocrinology , Istanbul , Turkey.
authors.forename: Heves
authors.initials: H
authors.lastname: Kirmizibekmez
authors.affiliation: e Umraniye Training and Research Hospital , Department of Ophthalmology , Istanbul , Turkey.
authors.forename: Betul Onal
authors.initials: BO
authors.lastname: Gunay
authors.affiliation: f Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital , Department of Pediatric Endocrinology , Istanbul , Turkey.
authors.forename: Rahime Gul
authors.initials: RG
authors.lastname: Yesiltepe Mutlu
mesh_terms: D000293:Adolescent; D002648:Child; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis*; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009994:Osmolar Concentration; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry*; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Childhood; diabetes mellitus; dry eye; ocular surface; tear film osmolarity