Clinical Significance On The Role Of Inflammatory Factors In Diabetic Mellitus Patients With Symptomatic Moderate Dry Eye

Objective:To explore the role of inflammatory factors in the development of diabetic dry eye syndrome,and to provide a strong basis for the diagnosis and prevention of diabetes induced dry eye syndrome.Methods:To selected 162 patients from August 2016 to May 2017 in our ophthalmology outpatient department for treatment and hospitalization,and divided them into two groups:92 cases of diabetic dry eye group and 70 cases of normal control group.Among them,patients with no history of eye surgery,history of trauma,wearing history of contact lenses,and 3 months of history without ocular inflammation and systemic disease were included in the normal control group.The OSDI questionnaires,the Schirmer I test(SIt),the tear break-up time(TBUT),and the degree of fluorescein staining test(FLS)were compared between the two groups.Conjunctival goblet cell density was observed by imprint cytology;the expression of TGF-?1 in the conjunctival epithelial cells was detected by Immunocytochemistry staining.Enzyme-linked immunosorbent assay(ELISA)was used to detect the concentrations of IL-1? and IL-6 in the tears of the two groups,and the correlation between the above-mentioned test results and IL-6 levels in tears was analyzed in diabetic dry eye patients.Result:1.Compared with the normal control group,the mean OSDI of diabetic dry eye group was significantly higher(8.67 ± 7.28 vs 24.36 ± 9.81),with statistical significance(P<0.001).2.Compared with the normal control group,the average time of TBUT in the diabetic dry eye group(12.31 ± 2.69s vs 4.12 ± 2.58s)and the mean length of SIt(15.11 ± 4.34mm vs 6,89 ± 2.62mm)was statistically different(all P<0.001).Compared with the normal control group,the proportion of subjects with a SIt value<10 mm/5min and a TBUT value<10s in the diabetic dry eye group increased significantly,with statistical differences(all P<0.01).3.Compared with the normal control group,the scores of membrane fluorescein staining in the diabetic dry eye group(2.88 ±1.71 vs 4.29 ±2.13)were statistically significant(P = 0.032).Compared with the normal control group,the diabetic dry eye group was positive for FLS.The degree of the disease was significantly increased and there was a statistical difference(P<0.01).4.Compared with the normal control group,the expression of TGF-?1 in the conjunctival epithelial cells of the diabetic dry eye group was significantly increased(P<0.01).Compared with the normal control group,the expression of IL-1? and IL-6 in tears in diabetic mellitus patients with symptomatic moderate dry eye was significantly increased(P<0.05).5.Compared with normal control group,SIt value,TBUT value and conjunctival goblet cell density in diabetic dry eye group were negatively correlated with the expression of IL-6 in tear fluid(r = 0.70,P<0.001;r = 0.50,P = 0.02;r = 0.46,P =0.04).No correlation with tear clearance rate(r= 0.41,P= 0.06)..Conclusions:1.The expression of IL-1?,IL-6 and TGF-?1 was significantly increased in patients with diabetic dry eye,and it can be used as a clinical diagnostic index to evaluate the functional status of tear film and ocular surface.2.Inflammatory factors may play a key role in the pathogenesis of dry eye syndrome in diabetic patients.