Epidemiology study on incidence of dry eye in over 50-year residents with type 2 diabetes mellitus in Binhu district, Wuxi

Abstract

Background The complications of diabetic mellitus (DM) in ophthalmology are thought to be retinopathy and cataract mainly before.However,DM-associated ocular surface disease is increasingly concerned recently.The related epidemiological study can offer evidence for the prevention and treatment of DM-associated dry eyes.Objective This survey was to estimate the prevalence rate and risk factor of dry eyes in residents of type 2 DM aged ≥ 50 years in Binhu district,Wuxi.Methods The graduate-returning survey was used in selecting residents aged ≥ 50 years in Binhu district from September to December 2012 using a cross-sectional study.The questionnaire survey,examination of slit lamp microscope,dry eye-related examination and fundoscopy were performed in 631 individuals,and the risk factors of DM-associated dry eyes were evaluated.The data were compared and analyzed with SPSS software version 13.0.Written informed consent was obtained prior to any medical examination from each subject.Results DM was diagnosed in 703 subjects in this district,and 631 finished examinations,with the response rate 89.76％,including 260 males and 371 females.Dry eye was diagnosed in 49.45％ (312/631),with the male 105 cases (40.38％) and female 207 cases (55.80％).The proportion of dry eyes in 50-59,60-69,70-79 and over 80 years old groups was 32.05％,43.91％,19.23％ and 4.81％,respectively,with the highest constituent ratio in the 60-69 years old group.The incidence of dry eyes was significantly increased in the female subjects than those of male subjects in 50-59 and 60-69 years old groups (55.88％ versus 39.34％,x2 =4.61,P=0.03 ;58.78％ versus 37.04％,x2 =12.10,P=0.00).The relevant factors of DM-associated dry eyes were showed to be gender (x2 =14.52,P =0.00),smoking history (x2 =40.08,P =0.00),alcohol drinking history (x2 =130.20,P =0.00),allergic history (x2 =4.68,P =0.03),long-term usage of eyedrops (x2 =13.59,P =0.00),continual watching (x2=10.53,P=0.01) and high level education (x2=7.74,P=0.01).Dryness,foreign body sensation and burning sensation were primary symptoms,and the abnormality rates of breakup time of tear film (BUT),corneal fluorescence dyeing,Schirmer Ⅰ test were significantly higher in the DM-associated dry eye group than those in the non-dry eye group (x2 =199.66,48.88,40.80,all at P=0.00).The eye number of meibomian gland dysfunction and abnormal height of lacrimal river was evidently increased in the DM-associated dry eye group compared with non-dry eye group (x2 =39.09,11.45,both at P＜0.05).Conclusions Dry eye is a multi-factorial surface disease.The incidence of dry eye is higher in DM patients than that in non-DM patients.It is necessary to promote the diabetic population-bases prevention and treatment for dry eye in the community. Key words: Diabetes mellitus/complication; Dry eye; Prevalence; Epidemiology; Risk factors; Crosssectional study