To analyze the effects of seasonal allergic conjunctivitis (SAC) on the eye surface of diabetes mellitus patients.

80 patients (160 eyes) who visited the Department of Ophthalmology, Nanjing University Hospital from February 2019 to August 2019 were selected. There were 49 males and 31 females, aged 41 to 76 years-old, with average age (58.5±8.2) years-old. 40 diabetic patients (80 eyes) diagnosed with active SAC were included in the observation group; 40 diabetic patients (80 eyes) with routine ophthalmic examination were included in the control group. Ocular surface diseases index (OSDI), Schirmer Ⅰ test (SⅠt), tear meniscus height (TMH), tear break-up time (BUT), fluorescein staining test (FL) and meibomian gland comprehensive score were observed and recorded at onset and after remission. All data was represented by Mean±SD. One-way analysis of variance was used to compare the ocular surface related parameters during onset and remission in the observation group with those in the control group, and Spearman test was used to correlate the parameters of each group.

There was no significant difference in gender (χ²=0.891, P>0.05)and in age, duration of diabetes, fasting blood glucose, glycosylated hemoglobin, best corrected visual acuity and intraocular pressure between two groups (t=0.925, 1.218, 0.787, 1.014, 0.962, 1.231; P>0.05). The OSDI, BUT, FL and meibomian gland composite scores of diabetic patients in SAC onset period were (44.79±17.26), (5.47±2.30) s, (5.47±2.30), (3.75±2.20), respectively; these dices of control group were (28.49±9.18), (10.39±3.66) s、(0.98±0.80), (2.83±1.95), respectively. After one-way analysis of variance, there were significant differences in OSDI, BUT, FL and meibomian gland composite scores between two groups of patients (F=36.387, 14.015, 4.293, 6.011; P<0.05). Compared with the control group, the OSDI, FL and meibomian gland scores of diabetic patients in SAC onset period were increased, but BUT was decreased with statistical significance difference between two groups (t=9.386, 8.230, 5.795, -6.016; P<0.05). After treatment and remission, various indicators were improved; OSDI and meibomian gland scores were still higher than the control group, but BUT was lower than the control group. OSDI, meibomian gland scores and BUT of patients′were (35.89±10.76), (1.10±0.84) and (8.40±3.72) s, respectively with statistical significance difference between two groups (t=4.587, 3.840, -6.233; P<0.05). There was no significant difference in the comparison of SⅠt and TMH between two groups of patients (F=2.185, 1.214; P>0.05). Spearman correlation analysis showed that in diabetes mellitus patients with SAC in onset in the observation group, OSDI was negatively correlated with SⅠt, TMH and BUT with statistical significance difference (r=-0.652, -0.640, -0.343; P<0.05); positively correlated with FL and meibomian gland scores with statistical significance difference (r= 0.679, 0.817; P<0.05). SⅠt was positively correlated with TMH with statistical significance difference (r= 0.745, P<0.05). BUT was negatively correlated with FL and meibomian gland comprehensive scores with statistical significance difference (r=-0.521, -0.559; P<0.05). In diabetes mellitus patients with SAC in remission in the observation group, OSDI was negatively correlated with TMH and BUT with statistical significance difference (r=-0.321, -0.398; P<0.05); and positively correlated with meibomian gland scores with statistical significance difference (r=0.272, P<0.05). SⅠt was positively correlated with TMH with statistical significance difference (r=0.799, P<0.05). BUT was negatively correlated with FL and meibomian gland comprehensive score with statistical significance difference (r=-0.697, -0.602; P<0.05).

SAC had an effect on OSDI, FL, BUT and meibomian gland score in DM patients. but has little effect on SⅠt and TMH. OSDI, BUT and meibomian gland score recover slowly in remission stage of SAC; OSDI was in good agreement with ocular surface parameters such as SⅠt, TMH, BUT, FL and meibomian gland comprehensive score.