Conjunctival surface changes in diabetics: an unusual cytological study

  • Adeeb A Khan
  • Divya Kesarwani
  • Shaista M Vasenwala
  • A K Amitava
  • Zia Siddiqui
  • Kafil Akhtar
Keywords: Diabetic retinopathy, Conjunctival impression cytology, Dry eye, Cytology

Abstract

Background: To study the conjunctival surface changes in diabetics with and without retinopathy, its relation to systemic factors and comparison to control.Methods: In this study, 123 eyes of 74 subjects were divided into two study groups (Diabetes with and without retinopathy) and control. Diabetes mellitus (DM) without retinopathy comprised of 34 cases with 50 eyes, diabetic retinopathy (DR) of 19 cases with 33 eyes and control of 21 cases with 40 eyes. Conjunctival impression cytology (CIC) was compared in the three groups. We also noted relationship of CIC to the sign and symptoms of dry eye, duration of diabetes, the status of retinopathy and metabolic control in diabetes.Results: CIC analysis showed that goblet cell density (GCD) was significantly lower in diabetics as compared to controls which was related to worsening retinopathy and dry eye symptoms(p<0.05) but not with duration of diabetes and poor metabolic control. Highly significant conjunctival squamous metaplasia (CSM) was seen in diabetics as compared to control group. (p<0.0001) The median CSM grade was poorer with long duration diabetes and worsening retinopathy (p<0.015), with no relation to dry eye symptoms and metabolic control.Conclusion: Conjunctival surface changes in diabetics include goblet cell loss and CSM. Interestingly, diabetics with retinopathy had significantly worse changes on CIC analysis than those without it, and both groups showed worse changes than controls.

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Published
2014-09-28
Section
Original Article