AIM: To investigate the changes of tear film function and symptoms of dry eye in patients with diabetic peripheral neuropathy(DPN).

METHODS: Retrospective case-control study was conducted. A total of 59 patients(59 eyes)with tear film abnormalities who were diagnosed with type 2 diabetes mellitus(T2DM)were divided into group T2DM(31 cases, 31 eyes)and group DPN(28 cases, 28 eyes)depending on the presence or absence of diabetic peripheral neuropathy. Patients at the Department of Ophthalmology who met the criteria of tear film abnormalities and without diabetes were selected as the non-T2DM group(33 cases, 33 eyes). All subjects were completed the Ocular Surface Disease Index(OSDI), and underwent fluorescein breakup time test(BUT), fluorescein staining(FL), Schirmer Ⅰ test(SchirmerⅠ)and infrared meibomian gland photography.

RESULTS: A statistically significant difference was observed among the three groups for the BUT values(F=9.43, P<0.01), and differences still existed between any two of the three groups(P<0.05). There were no statistically differences among the three groups for the Schirmer Ⅰ and the positive rates of fluorescein staining(P>0.05). There was statistically difference among the three groups for meibomian gland loss scores(χ²=8.433, P<0.05). Statistically differences only were observed between DPN group with non-T2DM group or T2DM group(P<0.05). Difference of OSDI scores of three groups was statistically significant(P<0.05). There was no significant difference between T2DM group and non-T2DM group(P>0.05), meanwhile between DPN group with non-T2DM group or T2DM group, the differences were statistically significant(P<0.05).

CONCLUSION: T2DM patients with DPN are more likely to have shorter BUT and more meibomian gland loss than T2DM patients without DPN and patients without T2DM, but the symptoms of dry eye are less obvious. Ocular surface abnormalities should be followed up closely in DPN patients.