Microbiological Characteristics of Ocular Surface Associated With Dry Eye in Children and Adolescents With Diabetes Mellitus

PURPOSE: To analyze the characteristics of ocular surface microbial composition in children and adolescents with diabetes mellitus and dry eye (DE) by tear analysis. METHODS: We selected 65 children and adolescents aged 8 to 16 years with DE and non–DE diabetes mellitus and 33 healthy children in the same age group from the Shanghai Children and Adolescent Diabetes Eye Study. Tears were collected for high-throughput sequencing of the V3 and V4 region of 16S rRNA. The ocular surface microbiota in diabetic DE (DM-DE; n = 31), diabetic with non–DE (DM-NDE; n = 34), and healthy (NDM; n = 33) groups were studied. QIIME2 software was used to analyze the microbiota of each group. RESULTS: The DM-DE group had the highest amplicon sequence variants, and the differences in α-diversity and β-diversity of micro-organisms in the ocular surfaces of DM-DE, diabetic with non-DE, and healthy eyes were statistically significant (P < 0.05). Bacteroidetes (15.6%), Tenericutes (9.3%), Firmicutes (21.8%), and Lactococcus (7.9%), Bacteroides (7.8%), Acinetobacter (3.9%), Clostridium (0.8%), Lactobacillus (0.8%) and Streptococcus (0.2%) were the specific phyla and genera, respectively, in the DM-DE group. CONCLUSIONS: Compared with the patients with non–DE and healthy children, the microbial diversity of the ocular surface in children and adolescents with diabetes mellitus and DE was higher with unique bacterial phyla and genera composition.