Evidence mapPaperPMID 41269387Full record

ReviewInternational ophthalmology2025

Alterations of the ocular surface during diabetes: molecular mechanisms and therapeutic strategies.

J C Quintana-Pérez, F Tamay-Cach, S A Guillen-Castro, F J Castañeda-Ibarra, M G Arellano-Mendoza, A S Valdez-Guerrero, D Alemán-González-Duhart

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In one paragraph

Review in International ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

J C Quintana-PérezLaboratorio de Investigación en Bioquímica Aplicada, Sección de Estudios de Posgrado e Investigación y Departamento de Formación Básica Disciplinaria, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Casco de Santo Tomas, Miguel Hidalgo, 11340, Mexico City, Mexico.
F Tamay-CachLaboratorio de Investigación en Bioquímica Aplicada, Sección de Estudios de Posgrado e Investigación y Departamento de Formación Básica Disciplinaria, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Casco de Santo Tomas, Miguel Hidalgo, 11340, Mexico City, Mexico.
S A Guillen-CastroLaboratorio de Investigación en Bioquímica Aplicada, Sección de Estudios de Posgrado e Investigación y Departamento de Formación Básica Disciplinaria, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Casco de Santo Tomas, Miguel Hidalgo, 11340, Mexico City, Mexico.
F J Castañeda-IbarraLaboratorio de Investigación en Bioquímica Aplicada, Sección de Estudios de Posgrado e Investigación y Departamento de Formación Básica Disciplinaria, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Casco de Santo Tomas, Miguel Hidalgo, 11340, Mexico City, Mexico.
M G Arellano-MendozaLaboratorio de Investigación en Enfermedades Crónico-Degenerativas, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Casco de Santo Tomas, Miguel Hidalgo, 11340, Mexico City, Mexico.
A S Valdez-GuerreroLaboratorio de Investigación en Bioquímica Aplicada, Sección de Estudios de Posgrado e Investigación y Departamento de Formación Básica Disciplinaria, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Casco de Santo Tomas, Miguel Hidalgo, 11340, Mexico City, Mexico. amvaldezg@ipn.mx.
D Alemán-González-DuhartDepartamento de Formación Básica Interdisciplinaria, Centro Interdisciplinario de Ciencias de la Salud-Unidad Santo Tomás, Instituto Politécnico Nacional, Av. de los Maestros S/N, Casco de Santo Tomás, Miguel Hidalgo, 11340, Mexico City, Mexico. dagonzalezd@ipn.mx.

Funding

Secretaría de Investigación y Posgrado, Instituto Politécnico Nacional SIP20254031
6 · The paper itself

Abstract

backgroundChronic hyperglycemia disrupts ocular surface homeostasis through oxidative stress, inflammation, autonomic neuropathy, and microvascular damage. These alterations contribute to dry eye disease, conjunctival changes, and corneal neuropathy, yet the underlying mechanisms are not fully understood. This review explores the molecular, cellular, and physiological pathways involved in diabetes-related ocular surface damage and summarizes current and emerging therapeutic approaches.

methodsA narrative review of peer-reviewed literature was performed, integrating clinical, histological, and molecular findings on conjunctival alterations, tear film dysfunction, oxidative stress, microbiota changes, and corneal nerve impairment in diabetic patients. Both established treatments and therapies under clinical or preclinical development were examined.

resultsHyperglycemia induces the accumulation of advanced glycation end-products, activates RAGE signaling, and increases ROS production, leading to endothelial dysfunction, goblet cell loss, and epithelial barrier compromise. Tear film instability results from lacrimal gland microvascular injury, Meibomian gland dysfunction, and reduced corneal sensitivity secondary to neuropathy. Corneal neuropathy-marked by reduced sub-basal nerve density, nerve tortuosity, punctate keratitis, and delayed healing-affects up to 70% of patients and may precede diabetic retinopathy. Treatments include lubricants, autologous serum, topical insulin, amniotic membranes, and tarsorrhaphy. Promising experimental therapies include neurotrophic factors, α-lipoic acid, PEDF, resolvins, GLP-1-based agents, and gene-based strategies.

conclusionDiabetes profoundly impacts the ocular surface through oxidative, inflammatory, neurogenic, and microvascular mechanisms that compromise tear film stability and corneal health. Early detection and targeted management are crucial to prevent progression to neurotrophic keratopathy. Further research is needed to refine mechanism-driven therapies.

Indexed as

ConjunctivaCorneaCorneal DiseasesDiabetes MellitusDry Eye SyndromesHumansOxidative StressTearsCorneal neuropathyDiabetesDry eye diseaseLacrimal gland dysfunctionOcular surface

Identifiers

PMID41269387

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.