The Auxiliary Diagnostic Value Of Eye Observation Instrument In Diabetic Microangiopathy

Objective: The auxiliary diagnostic value of eye observation instrument in type 2 diabetic microangiopathy was explored,in order to achieve the purpose of distinguishing patients with microangiopathy,and to provide theoretical basis for dialectical treatment according to white eye characteristics and TCM symptoms.Methods: We used Cross-sectional study and Diagnostic test methods.Patients with type 2 diabetes mellitus were included who were hospitalized in the Department of Endocrinology of Shandong Provincial Hospital from July 2021 to May 2022.Collect general information of patients and eye morphology,area and color characteristics,and summarize TCM symptoms.Then,taking clinical examination as the gold standard,the differences in white eye characteristics and TCM symptoms were compared between patients with microangiopathy and patients without microangiopathy.Finally,the auxiliary diagnostic value of the different indicator was evaluated.The patients with microvascular complications were further divided into different subgroups according to DR grade or DN stage,and the same research method was used to compare the differences in white eye characteristics and TCM symptoms between the subgroups.Finally,the auxiliary diagnostic value of the different indicator was evaluated.Results:1.Compared the white eye characteristics of T2DM patients without microangiopathy and with microangiopathy,the score of “hill” was significantly different(p<0.001),and the group with microangiopathy was higher than the group without microangiopathy.The area under the ROC curve(AUC)corresponding to “hill” was 0.621,p=0.001.It had auxiliary diagnostic value for diabetic microangiopathy when the score of “hill” was more than 2.And the combination of “hill”,duration or CysC could increase the diagnostic efficiency of a single indicator,among which the combination of “hill”,age,duration and CysC had the largest diagnostic efficiency,whose AUC was 0.739,p<0.001.There were no significant differences in eye area characteristic and blood vessel color characteristic between the two groups.But there was a significant difference in the proportion of “phlegm and dampness syndrome” in TCM pattern(p<0.001),and the group with microangiopathy was higher than the group without microangiopathy.2.There were no differences in eye morphology,area,blood vessel color characteristics and TCM symptoms between patients those with DR only and those with both DR and DN in T2DM.3.Compared the white eye characteristics of T2DM patients with DN only and combined DN and DR,the score of “spot” was statistically different(p=0.036),and the combined DN and DR group was higher than that in DN group.The area under the ROC curve(AUC)corresponding to “spot” was 0.634,p=0.037.It had auxiliary diagnostic value when the score of “spot” was more than 5,but the combination of “spot”,duration or CysC did not increase the diagnostic efficacy of a single indicator,and the combination of “spot”,duration and CysC had the largest diagnostic efficiency,whose AUC was 0.640,p=0.029.There were no significant differences in the eye area,blood vessel color characteristics and TCM symptoms between the two groups.4.In T2DM patients suffering from DR and DN at the same time,whether they were divided into four groups according to DR grade or three groups according to DN stage,there were no differences in eye morphology,area,blood vessel color characteristics and TCM symptoms between the subgroups.Conclusion:The eye morphology “hill” has auxiliary diagnostic value in distinguishing T2DM patients with microangiopathy,and has higher diagnostic value in combination with age,duration and CysC.The proportion of “Phlegm and dampness syndrome” in patients with microangiopathy is higher than that of patients without microangiopathy.However,the eye observation instrument does not help distinguish the patients with different DR grades or DN stages.