DM patients with advanced diabetic retinopathy have more dry eye issues associated with neurotrophic keratopathy which could cause severe vision loss due to cornea ulcer or neurotrophic ulcer, this could lead an increased expression of proinflammatory cytokines, like inducible protein-10 (IP-10) and monocyte chemoattractant protein-1 (MCP-1), and decreased levels of antiangiogenic cytokines which demonstrate that an inflammatory reaction occurs in the ocular surface of diabetic patients [162]. This evidence concerns the gene CCL2 and dry eye syndrome.