Diabetic Neuropathy Linked to Dry Eye

TOPLINE:
Patients with type 2 diabetes and moderate to severe peripheral neuropathy have a 3.8 times higher risk for dry eye disease.
METHODOLOGY:
Researchers conducted a prospective, cross-sectional study on 63 men and women with type 2 diabetes being treated at a single hospital in Australia.
Patients were assessed for dry eye disease using questionnaires, tear osmolarity, lipid layer thickness, and other tests.
Researchers assessed the presence of neuropathy using Toronto consensus criteria. The severity was evaluated using the Total Neuropathy Scale, categorizing participants into groups with no/mild and moderate/severe neuropathy.
Corneal confocal microscopy was used to investigate the link between the structure of the corneal nerve and dry eye disease.
TAKEAWAY:
Dry eye disease was diagnosed in 50% patients, with a notably higher percentage in the group with moderate/severe neuropathy (n = 15; 73%) than in the group with no/mild neuropathy (n = 48; 42%; P = .03).
People in the moderate/severe neuropathy group had 3.8 times higher odds of developing dry eye disease (95% CI, 1.1-13.8; P = .03) than those in the no/mild neuropathy group.
Patients in the moderate to severe neuropathy group showed significant reductions in corneal fiber density, nerve branch density, and nerve fiber length.
Regression analysis showed a strong independent association between neuropathy scores and phenol red thread test (PRT) measurements (β = −0.333; 95% CI, −0.619 to −0.047; P = .023) and nerve fiber length (β = −0.219; P = .012).
IN PRACTICE:
“Patients with worsening peripheral neuropathy in type 2 diabetes exhibit a higher risk of developing dry eye disease,” the study authors wrote. “Reduced tear secretion with increasing severity of peripheral neuropathy is suggestive of peripheral neuropathy contributing to aqueous insufficiency.”
SOURCE:
This study was led by Shyam Sunder Tummanapalli, PhD, of the University of New South Wales in Sydney, Australia. It was published online on September 16 in Optometry and Vision Science.
LIMITATIONS:
The cross-sectional design of this study limited the ability to determine causality between diabetic peripheral neuropathy, dry eye disease, and corneal nerve injury. This study was mainly powered to detect differences in tear breakup time, not other analyses, which may have led to minimal statistical significance in DEQ-5 scores and PRT values.
DISCLOSURES:
None reported.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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