{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:47:11Z","timestamp":1793234831121,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate dynamic thiol\/disulfide homeostasis in the tear fluid of patients with type 2 diabetes and to investigate its relationship with the presence of diabetic retinopathy (DR), considering it as a potential biomarker of oxidative stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 96 individuals were included in the study. Participants were divided into three groups: 32 patients with diabetic retinopathy (Group 1, DR (+)), 31 patients with diabetes but without retinopathy (Group 2, DR (\u2013)), and 33 healthy volunteers (Group 3). All participants underwent a comprehensive ophthalmological examination, including best-corrected visual acuity, slit-lamp biomicroscopy, and fundus evaluation. Tear samples were collected using Schirmer strips and stored in phosphate-buffered Eppendorf tubes at \u221280 \u00b0C until analysis. Total thiol, native thiol, and disulfide levels were analyzed using a spectrophotometric method. Patients with a history of intraocular surgery, trauma, glaucoma, or systemic diseases other than diabetes were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were statistically significant differences between the groups in terms of total thiol, disulfide, disulfide\/total thiol, and disulfide\/native thiol ratios (p\u2009&lt;\u20090.001). Total thiol levels were significantly lower, while disulfide levels and ratios were significantly higher in the DR (+) group. No significant difference was found in native thiol levels (p\u2009=\u20090.194). HbA1c and fasting blood glucose levels were significantly higher in the DR (+) group compared to the other groups (p\u2009&lt;\u20090.001). Central macular thickness was also significantly greater in the DR (+) group (p\u2009&lt;\u20090.001). Correlation analysis revealed a positive and significant relationship between HbA1c and fasting blood glucose (r\u2009=\u20090.551; p\u2009&lt;\u20090.01), whereas no significant correlation was found between central macular thickness and glycemic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The increased disulfide levels and disulfide ratios in the tear fluid of patients with diabetic retinopathy suggest a shift in thiol\/disulfide homeostasis toward oxidative stress. These tear-based biomarkers may serve as valuable tools for the early diagnosis and monitoring of diabetic retinopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721251412054","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T18:19:01Z","timestamp":1768846741000},"page":"1033-1041","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Thiol-Disulfide homeostasis in tear fluid: Alterations associated with diabetic retinopathy"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6822-9077","authenticated-orcid":false,"given":"Suzan","family":"Do\u011fruya","sequence":"first","affiliation":[{"name":"U\u015fak University Training and Research Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Funda","family":"Karaba\u011f","sequence":"additional","affiliation":[{"name":"U\u015fak University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.12696"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/43603"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2011.05.002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2014.09.026"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2013.06.040"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3906\/sag-2201-132"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3906\/sag-2007-229"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2019.08.007"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.02.019"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2022.11.006"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10517-023-05963-9"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ab.2021.114295"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-015-0661-5"},{"key":"e_1_3_2_15_2","first-page":"236","article-title":"Dynamic thiol disulfide balance in diabetes with and without retinopathy","volume":"6","author":"Yuvaci I","year":"2021","unstructured":"Yuvaci I, Bayram N, Cakir I, et al. 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