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A Clinical Study of Meibomian Gland Dysfunction in Patients with Diabetes.

Shamsheer RP, Arunachalam C - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Bottom Line: The results were compared in both the groups to ascertain whether the frequency of MGD in diabetics is significantly more as compared to nondiabetics.P < 0.05 was considered as statistically significant.There was a significant increase in the frequency of MGD in diabetics as compared to the nondiabetics.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India.

ABSTRACT

Aims of the study: To study the frequency of meibomian gland dysfunction (MGD) in patients of diabetes mellitus with dry eye.

Materials and methods: A case-control cross sectional study.

Sampling: Purposive random sampling. Totally, 200 eyes of 100 patients of diabetes mellitus and an equal number of eyes of normal subjects as control, who were gender and age matched and all of whom were symptomatic for dry eye were assessed for MGD by noting the symptoms and determining the meibomian gland expression scale for volume and viscosity, and ocular surface staining with Lissamine green, and Fluorescein sodium. All the subjects were graded for the severity of MGD. The results were compared in both the groups to ascertain whether the frequency of MGD in diabetics is significantly more as compared to nondiabetics.

Statistical analysis: The data were analyzed by Chi-square test for significance. P < 0.05 was considered as statistically significant.

Results: There was a significant increase in the frequency of MGD in diabetics as compared to the nondiabetics.

Conclusion: Diabetes mellitus is associated with MGD.

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Related in: MedlinePlus

Oxford panel for grading of corneal and conjunctival staining
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Figure 1: Oxford panel for grading of corneal and conjunctival staining

Mentions: This was a cross-sectional, case-controlled study that evaluated 200 eyes of 100 diabetic (diabetic group) and 100 nondiabetic individuals (control group) respectively. The age range of both groups was from 40 to 65 years. Both the diabetic and control groups were enrolled from patients attending the hospital eye out patient department. The diabetic state was determined either by the history of medication for diabetes or an abnormal random blood sugar level of >200 mg/dl or HbA1C of >6.5% or fasting blood sugar of >126 mg/dl.7 Patients with pterygium, thyroid eye disease, on medications such as antihistamines and tricyclic antidepressants and postocular or refractive surgery were excluded from the study. After obtaining ethical clearance and ensuring informed consent, participants were assigned to age and gender matched diabetic and control groups. A detailed history was elicited for symptoms of ocular surface irritation such as foreign body sensation, grittiness, dryness, burning, teary eyes, and itching. Patients with frequent and persistent symptoms were classified grade 2 or higher on the MGD grading system. A general physical examination and detailed ophthalmic examination were performed. Corneal staining of the eye by an unquantified method was done, wherein a strip of commercially marketed sodium fluorescein containing 1 mg fluorescein (Fluostrip; Contacare Ophthalmics and Diagnostics, Gujarat, India) was moistened with a drop of saline, any excess saline was shaken off and the strip was applied to the inferior palpebral surface. The staining pattern was evaluated within 2 min at the slit lamp with ×16 magnification. After an interval of 5 min, the ocular surface was stained in a similar fashion with Lissamine green strips (Akriti ophthalmic products) each containing 1.5 mg of Lissamine green per strip. Examination at the slit lamp with ×16 was performed at a standard time interval of 1 min after placement of impregnated strip of Lissamine Green in the inferior fornix as staining is both time and concentration dependent. Lissamine green staining of the conjunctiva and fluorescein staining of the cornea were graded according to the Oxford grading scale7 as mild (grade I and II) moderate (grade III), and severe (grade IV and V) [Figure 1].


A Clinical Study of Meibomian Gland Dysfunction in Patients with Diabetes.

Shamsheer RP, Arunachalam C - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Oxford panel for grading of corneal and conjunctival staining
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660533&req=5

Figure 1: Oxford panel for grading of corneal and conjunctival staining
Mentions: This was a cross-sectional, case-controlled study that evaluated 200 eyes of 100 diabetic (diabetic group) and 100 nondiabetic individuals (control group) respectively. The age range of both groups was from 40 to 65 years. Both the diabetic and control groups were enrolled from patients attending the hospital eye out patient department. The diabetic state was determined either by the history of medication for diabetes or an abnormal random blood sugar level of >200 mg/dl or HbA1C of >6.5% or fasting blood sugar of >126 mg/dl.7 Patients with pterygium, thyroid eye disease, on medications such as antihistamines and tricyclic antidepressants and postocular or refractive surgery were excluded from the study. After obtaining ethical clearance and ensuring informed consent, participants were assigned to age and gender matched diabetic and control groups. A detailed history was elicited for symptoms of ocular surface irritation such as foreign body sensation, grittiness, dryness, burning, teary eyes, and itching. Patients with frequent and persistent symptoms were classified grade 2 or higher on the MGD grading system. A general physical examination and detailed ophthalmic examination were performed. Corneal staining of the eye by an unquantified method was done, wherein a strip of commercially marketed sodium fluorescein containing 1 mg fluorescein (Fluostrip; Contacare Ophthalmics and Diagnostics, Gujarat, India) was moistened with a drop of saline, any excess saline was shaken off and the strip was applied to the inferior palpebral surface. The staining pattern was evaluated within 2 min at the slit lamp with ×16 magnification. After an interval of 5 min, the ocular surface was stained in a similar fashion with Lissamine green strips (Akriti ophthalmic products) each containing 1.5 mg of Lissamine green per strip. Examination at the slit lamp with ×16 was performed at a standard time interval of 1 min after placement of impregnated strip of Lissamine Green in the inferior fornix as staining is both time and concentration dependent. Lissamine green staining of the conjunctiva and fluorescein staining of the cornea were graded according to the Oxford grading scale7 as mild (grade I and II) moderate (grade III), and severe (grade IV and V) [Figure 1].

Bottom Line: The results were compared in both the groups to ascertain whether the frequency of MGD in diabetics is significantly more as compared to nondiabetics.P < 0.05 was considered as statistically significant.There was a significant increase in the frequency of MGD in diabetics as compared to the nondiabetics.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India.

ABSTRACT

Aims of the study: To study the frequency of meibomian gland dysfunction (MGD) in patients of diabetes mellitus with dry eye.

Materials and methods: A case-control cross sectional study.

Sampling: Purposive random sampling. Totally, 200 eyes of 100 patients of diabetes mellitus and an equal number of eyes of normal subjects as control, who were gender and age matched and all of whom were symptomatic for dry eye were assessed for MGD by noting the symptoms and determining the meibomian gland expression scale for volume and viscosity, and ocular surface staining with Lissamine green, and Fluorescein sodium. All the subjects were graded for the severity of MGD. The results were compared in both the groups to ascertain whether the frequency of MGD in diabetics is significantly more as compared to nondiabetics.

Statistical analysis: The data were analyzed by Chi-square test for significance. P < 0.05 was considered as statistically significant.

Results: There was a significant increase in the frequency of MGD in diabetics as compared to the nondiabetics.

Conclusion: Diabetes mellitus is associated with MGD.

Show MeSH
Related in: MedlinePlus