Two-Year Incidence and Associated Factors of Dry Eye Among Residents in Shanghai Communities With Type 2 Diabetes Mellitus

Objective: To evaluate the 2-year incidence and associated factors of dry eye (DE) among community residents with type 2 diabetes mellitus (DM). Methods: For confirmed type 2 DM residents in the Xinjing community of Shanghai in China, 2 surveys on DE and related factors were performed in 2016 and 2018. The survey content included general information, subjective symptom questionnaires, tear-film break-up time test, Schirmer I test, corneal fluorescence staining (FL), slit-lamp examination, and examination of blood and urine samples. Symptoms of depression were evaluated using the Center for Epidemiologic Studies Depression (CES-D) scale. Dry eye was diagnosed based on the diagnostic standards developed by the Asia Dry Eye Society in 2016. Results: The 2-year incidence of DE among 460 type 2 DM residents was 33.7% (95% confidence interval [CI]=29.6%-38.3%). The incidence of DE significantly increased with increasing age (P<0.01). The incidence among women (35.7%) was not statistically significant compared with that of men (31.0%). In the multivariate logistic regression model, age (odds ratio [OR]=1.03, 95% CI=1.01-1.06,P=0.04), corneal sensitivity (OR=0.97, 95% CI=0.94-0.99,P=0.03), and depressive symptom score (OR=1.04, 95% CI = 1.00-1.08,P=0.04) were associated factors for the incidence of DE. In the CES-D scale, two items, I felt that everything I did was an effort and I felt sad, were significantly correlated with DE onset. Conclusion: The incidence of DE among community residents with type 2 DM was high. Screening for DE among DM residents, especially residents with advanced age, corneal hypoesthesia, and depression, should be strengthened.