Features of eyelid microcirculation in chronic mixed blepharitis and type 2 diabetes mellitus

BACKGROUND: Microcirculatory dysfunction in patients with diabetes mellitus leads to tissue trophic insufficiency, reduction of adaptation reserves. It is possible to perform lifetime assessment of structural and functional changes in the microcirculation system by laser Doppler flowmetry. The presence of microcirculatory disorders is established in eyelids in chronic blepharitis and meibomian gland dysfunction. The article presents the results of the study concerning the peculiarities of neoangiogenesis as a mechanism of development of chronic blepharitis and meibomian gland dysfunction in diabetes mellitus (DM).

AIM: to reveal the peculiarities of microcirculatory disorders of the eyelid in chronic mixed blepharitis in patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS: The study was conducted in 57 patients: 37 patients with chronic mixed bilateral blepharitis and a verified diagnosis of T2DM (group 1, n=74 eyes, average age 69.5 ± 7.5 years; subgroup 1a, n=38 eyes — patients with T2DM and glycated hemoglobin average level (HbA_1с) 6.7±1.2; subgroup 1b, n=36 eyes — patients with T2DM and HbA_1с average level 8.2±1.3) and 20 patients with chronic mixed bilateral blepharitis without signs of DM (group 2, n=40 eyes, mean age 67.2±4.3 years). Laser Doppler flowmetry was performed on the device «LAZMA MC-1».

RESULTS: In patients with chronic blepharitis against the background of T2DM the development of ischemia of the eyelid tissue with increasing tension of functioning of the regulatory systems of microcirculation blood flow and lymph flow was detected, and in persons without DM — venous stasis with moderate inhibition of vasomotor, respiratory and dominance of cardiac oscillations of blood flow, as well as insufficiency of neurogenic oscillations of lymph flow. In this case in 1a subgroup the dominance of neurogenic oscillations of blood flow was revealed, in 1b - myogenic. Microcirculatory changes of lymph flow in the 1b subgroup were more pronounced in comparison with the 1a subgroup.

CONCLUSION: The results proves the negative influence of T2DM on the microcirculatory bed of patients with chronic mixed blepharitis. The disorders detected by laser Doppler flowmetry vary depending on the HbA_1с.

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