口服降糖药和胰岛素对眼表治疗的影响

目的:描述和对比口服降糖药(OAD)和胰岛素治疗2型糖尿病患者眼表的效果。方法:在安卡拉卫生部培训和研究医院就诊的20例40眼口服降糖药患者,20例40眼胰岛素治疗患者,对照组的10例非糖尿病人作为研究对象。对所有患者进行常规眼科检查,Schirmer试验,泪膜破裂时间分析和结膜印迹细胞学分析.比较三组的泪液功能参数,杯状细胞密度和鳞状上皮化生等级。记录视网膜病变及眼表疾病之间的关系。结果:口服降糖药患者泪膜破裂时间值明显低于其他组(P<0.05)。三组的杯状细胞密度和鳞状上皮化生等级相近。上皮细胞稍大,呈现更多的多边形的眼的中位数级为1级,并且嗜酸性染色胞浆和杯状细胞数量减少。视网膜病变与眼表疾病不相关。结论:口服降糖药患者的角膜前泪膜稳定性比其他组差。各组的印迹细胞学分析结果相似。

Effects of oral antidiabetic drugs and insulin treatment on ocular surface

AIM: To describe and compare ocular surface changes in type 2 diabetes patients treated either oral antidiabetic drugs(OAD)or insulin.

METHODS: Forty eyes of twenty patients treated with OAD, 40 eyes of 20 patients treated with insulin and 10 non-diabetic controls seen at the Ministry of Health Ankara Educational and Research Hospital were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis and conjunctival impression cytology analysis. Patients in three groups were compared for tear function parameters, goblet cell density and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorders were noted.

RESULTS: The tear film break-up time values were significantly lower at patients treated with OAD(P<0.05). Goblet cell density and squamous metaplasia grade were similar at all groups. The median grade was grade 1 in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm and goblet cells are decreased in number. Status of retinopathy did not seem to relate with ocular surface disorders.

CONCLUSION: Precorneal tear film stability is found to be worse in patients treated with OAD whereas impression cytology analysis is similar in all groups.