A systematic review on the impact of diabetes mellitus on the ocular surface.
Diabetes mellitus is associated with extensive morbidity and mortality in any human community. It is well understood that the burden of diabetes is attributed to chronic progressive damage in major end-organs, but it is underappreciated that the most superficial and transparent organ affected by diabetes is the cornea. Different corneal components (epithelium, nerves, immune cells and endothelium) underpin specific systemic complications of diabetes. Just as diabetic retinopathy is a marker of more generalized microvascular disease, corneal nerve changes can predict peripheral and autonomic neuropathy, providing a window of opportunity for early treatment. In addition, alterations of immune cells in corneas suggest an inflammatory component in diabetic complications. Furthermore, impaired corneal epithelial wound healing may also imply more widespread disease. The non-invasiveness and improvement in imaging technology facilitates the emergence of new screening tools. Systemic control of diabetes can improve ocular surface health, possibly aided by anti-inflammatory and vasoprotective agents.
Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.|Research Center of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong.
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KC
Shih
Research Center of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong.|Department of Medicine, The University of Hong Kong, Hong Kong.|State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong.
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KS
Lam
Singapore Eye Research Institute, National Eye Centre, Singapore.|Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Department of Ophthalmology, Singapore National Eye Center, Singapore.|Department of Ophthalmology, Duke-NUS Medical School, Singapore.
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L
Tong
D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology*; D006801:Humans