Evaluation of Dry Eye Disease Characteristics of Children With Type 1 and Type 2 Diabetes Mellitus and MODY

Abstract

Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups.The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g., blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); and (3) the use of any medication that can cause dry eye (antihistamines, antidepressants, decongestant, etc).Diabetes mellitus was diagnosed according to the American Diabetes Association8 criteria. MODY was diagnosed according to the ISPAD Clinical Practice Consensus Guidelines. 9All participants in the study underwent a detailed ophthalmological examination that included the use of best-corrected visual acuity with a Snellen chart, intraocular pressure measurement using a pneumatic tonometer, refraction measurement with an auto refractometer, and biomicroscopic examination including anterior and posterior segments. Attention was paid that none of the diabetic patients had any findings in favor of diabetic retinopathy in dilated fundus examinations. Blood samples were collected from the diabetic patients on the day of the examination to determine their fasting blood glucose levels and HbA1c values. The HbA1c values and the durations of DM were recorded.Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups.The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g., blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); and (3) the use of any medication that can cause dry eye (antihistamines, antidepressants, decongestant, etc).Diabetes mellitus was diagnosed according to the American Diabetes Association8 criteria. MODY was diagnosed according to the ISPAD Clinical Practice Consensus Guidelines.9All participants in the study underwent a detailed ophthalmological examination that included the use of best-corrected visual acuity with a Snellen chart, intraocular pressure measurement using a pneumatic tonometer, refraction measurement with an auto refractometer, and biomicroscopic examination including anterior and posterior segments. Attention was paid that none of the diabetic patients had any findings in favor of diabetic retinopathy in dilated fundus examinations. Blood samples were collected from the diabetic patients on the day of the examination to determine their fasting blood glucose levels and HbA1c values. The HbA1c values and the durations of DM were recorded.Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups.The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g., blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); and (3) the use of any medication that can cause dry eye (antihistamines, antidepressants, decongestant, etc).Diabetes mellitus was diagnosed according to the American Diabetes Association8 criteria. MODY was diagnosed according to the ISPAD Clinical Practice Consensus Guidelines.9All participants in the study underwent a detailed ophthalmological examination that included the use of best-corrected visual acuity with a Snellen chart, intraocular pressure measurement using a pneumatic tonometer, refraction measurement with an auto refractometer, and biomicroscopic examination including anterior and posterior segments. Attention was paid that none of the diabetic patients had any findings in favor of diabetic retinopathy in dilated fundus examinations. Blood samples were collected from the diabetic patients on the day of the examination to determine their fasting blood glucose levels and HbA1c values. The HbA1c values and the durations of DM were recorded.Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups.The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g., blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); and (3) the use of any medication that can cause dry eye (antihistamines, antidepressants, decongestant, etc).Diabetes mellitus was diagnosed according to the American Diabetes Association8 criteria. MODY was diagnosed according to the ISPAD Clinical Practice Consensus Guidelines.9All participants in the study underwent a detailed ophthalmological examination that included the use of best-corrected visual acuity with a Snellen chart, intraocular pressure measurement using a pneumatic tonometer, refraction measurement with an auto refractometer, and biomicroscopic examination including anterior and posterior segments. Attention was paid that none of the diabetic patients had any findings in favor of diabetic retinopathy in dilated fundus examinations. Blood samples were collected from the diabetic patients on the day of the examination to determine their fasting blood glucose levels and HbA1c values. The HbA1c values and the durations of DM were recorded.Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups.The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g., blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); and (3) the use of any medication that can cause dry eye (antihistamines, antidepressants, decongestant, etc).Diabetes mellitus was diagnosed according to the American Diabetes Association8 criteria. MODY was diagnosed according to the ISPAD Clinical Practice Consensus Guidelines.9All participants in the study underwent a detailed ophthalmological examination that included the use of best-corrected visual acuity with a Snellen chart, intraocular pressure measurement using a pneumatic tonometer, refraction measurement with an auto refractometer, and biomicroscopic examination including anterior and posterior segments. Attention was paid that none of the diabetic patients had any findings in favor of diabetic retinopathy in dilated fundus examinations. Blood samples were collected from the diabetic patients on the day of the examination to determine their fasting blood glucose levels and HbA1c values. The HbA1c values and the durations of DM were recorded.Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups.The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g. , blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); and (3) the use of any medication that can cause dry eye (antihistamines, antidepressants, decongestant, etc).Diabetes mellitus was diagnosed according to the American Diabetes Association8 criteria. MODY was diagnosed according to the ISPAD Clinical Practice Consensus Guidelines.9All participants in the study underwent a detailed ophthalmological examination that included the use of best-corrected visual acuity with a Snellen chart, intraocular pressure measurement using a pneumatic tonometer, refraction measurement with an auto refractometer, and biomicroscopic examination including anterior and posterior segments. Attention was paid that none of the diabetic patients had any findings in favor of diabetic retinopathy in dilated fundus examinations. Blood samples were collected from the diabetic patients on the day of the examination to determine their fasting blood glucose levels and HbA1c values. The HbA1c values and the durations of DM were recorded.Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular diseases, had applied at the ophthalmology clinic for a routine eye examination, and were age-matched and sex-matched with the study groups. The inclusion criteria for the diabetic participants were being younger than 18 years old, having no systemic diseases aside from DM (type-1, type-2, or MODY), the absence of any corneal or conjunctival disease, no history of topical drug use, and the absence of any chronic ocular disease or any structural abnormality aside from a cylindrical or spherical refractive error that was <= 1.00 diopter (D). All of the diabetic participants had regulated blood sugar, and none of them had any known systemic diabetic complications. Diabetic patients whose duration of diagnosis was known and who had records from the time of the diagnosis were included in the study. The exclusion criteria for the study were as follows: (1) a history of chronic eye disease aside from a refractive error (e.g., blepharitis or meibomian gland disorder, dry eye disease (DED), ocular allergy, cataract, uveitis, glaucoma, and retinopathy of prematurity), structural eye abnormality (persistent fetal vasculature and anterior segment dysgenesis), ocular surgery; (2) having any systemic disease aside from type-1, type-2, and MODY DM (Down syndrome, Fabry disease, Wilson syndrome, etc); ;