Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3014
Peer-review started: September 13, 2021
First decision: November 22, 2021
Revised: December 24, 2021
Accepted: March 15, 2022
Article in press: March 15, 2022
Published online: April 6, 2022
Processing time: 197 Days and 0.5 Hours
Dry eye syndrome (DES) decreases the quality of life and is associated with type 2 diabetes mellitus (T2DM). The prevalence of DES increases with multiple complications worldwide. Blink reflex (BR) can be used to assess the corneal nerve closed-loop morphology, but it is unclear whether it could be used in DES. This study helps understand more about corneal nerve morphology in patients with DES.
DES was significantly associated with T2DM, thus with the HBA1c level. However, the underlying mechanism of DES in T2DM is still unclear. This study will help determine the relationship between corneal nerves morphology and DES abnormalities in patients with T2DM.
The BR changes the corneal nerve morphology in patients with DES having T2DM is unclear. Thus, the objective of this study is to investigate corneal nerve fibers, and corneal nerve closed loop function in patients with DES having T2DM or not.
In this study, a total of 131 patients were enrolled from the ophthalmology and endocrinology Operationalized Psychodynamic Diagnosis with or without dry eye complaints. The tear film break-up time, Schirmer I test, in vivo confocal microscopy, and BR have performed accordingly after grouping. Data were presented as mean ± SD, and statistical analysis was performed using SPSS Statistics 16.0. This cross-sectional study is one of the primary studies to uncover the BR changes in these patients.
The findings of this study revealed that among this four DEwDM (n = 56), DMnDE (n = 22), DEnDM (n = 33), and nDMnDE (n = 20) groups, the nerve fiber length was reduced in three groups. The R1 Latency of BR increased in one group, suggesting changes in the corneal nerve morphology in DES patients with or without T2DM. The role of BR changes in DES with or without T2DM needs further assessment through future studies.
Further research is needed on the corneal morphology and neurological function in DES patients having T2DM in the future to provide clinical benefits to these patients. Moreover, OGTT or HBA1c as the diagnostic test should be used in future studies. The number of patients with DES needs to be increased in future studies.
This study observed that T2DM and DES had abnormal corneal morphology and function, whereas T2DM or DES alone had only abnormal corneal morphology. Therefore, future research should focus specifically on T2DM patients and DES and their morphological and functional improvements of corneal nerve.