A Review of Manifestations of Diabetes Mellitus in the Anterior Eye and Cornea

Herse, Peter

doi:10.1097/00006324-198803000-00013

Cited by 104 publications

(81 citation statements)

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“…8,[13][14][15] There are several reports describing patients with systemic diseases as showing changes in blinking patterns; increased blinking rates in patients with schizophrenia 1 4 or dry eye, 8 and decreased blinking rates in patients with parkinsonism 1 3 or panic disorder. 1 5 Patients with schizophrenia, parkinsonism, or panic disorder were excluded from this study, but some with dry eye may have been included. In previous studies of diabetic patients, tear breakup time and the results of the Schirmer test were decreased, suggesting dry eye, and corneal sensitivity was decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with this disease often develop not only diabetic retinopathy but also keratoepitheliopathies, such as superficial punctate keratopathy, recurrent corneal erosion, and persistent epithelial defects. [1][2][3][4] Diabetic keratoepitheliopathy has been attributed to quantitative and qualitative abnormalities in tear secretion, 1 decreased corneal sensitivity, 1,2 and poor adhesion of regenerating epithelial cells. 3 We also found that qualitative abnormalities in tear secretion such as nonuniformity of the tear lipid layer and decreased tear breakup time, and corneal sensitivity were possibly relevant to diabetic keratoepitheliopathy.…”

Section: Introductionmentioning

confidence: 99%

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Blinking and superficial punctate keratopathy in patients with diabetes mellitus

Inoue

Okugawa

Amano

et al. 2004

Eye

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Aim To evaluate blinking patterns in patients with diabetes mellitus and whether blinking contributes to the formation of superficial punctate keratopathy in diabetic patients. Methods We examined 163 patients with type II diabetes mellitus and 76 without diabetes. Blinks were recorded, analysed using six parameters, and compared between patients with and without diabetes. Multivariate regression analysis was performed to assess the influence of other ocular factors, such as status of tear lipid layer, tear breakup time, corneal sensitivity, the result of cotton thread test, or blinking rate related to superficial punctate keratopathy. Results In patients with diabetes, the average mean and maximum interblinking times were longer, the average coefficient of variation of interblinking time was higher, and the average blinking rates were lower than those in patients without diabetes. Multivariate regression analysis revealed that the status of tear lipid layer and tear breakup time were significantly relevant to superficial punctate keratopathy (Po0.01). Conclusion Interblinking time was longer in diabetic patients, resulting in a decreased blinking rate. The prevalence of superficial punctate keratopathy cannot be predicted from blinking patterns in patients with diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blinking and superficial punctate keratopathy in patients with diabetes mellitus

Inoue

Okugawa

Amano

et al. 2004

Eye

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“…32 Although the cause of theses abnormalities is not clear, some studies suggested that these disorders may be due to altered basal membrane structure and/or epithelial integrin expression, 28,31 increased glycosylation of type IV collagen 32 and fibronectin, abnormal regulation of the synthesis of extracellular matrix, increased IV collagen, and decreased laminin 31 and heparin sulfate. 27 As far as epithelial basal membrane alteration is concerned, people with DM show an accumulation of fibrillar and granular material between the epithelial cells and Bowman's membrane, thickening and multilayering of the basal membrane, 32,33 and accumulation of glycation end products (AGEs).…”

Section: Tear Filmmentioning

confidence: 99%

“…These disorders are associated with alterations in the basal membrane anchoring complex (anchoring fibrils, anchoring plaques, basal lamina, and hemidesmosomes) 27,28,33 resulting in a critical adherence of the basal membrane to the corneal stroma, causing delayed epithelial healing rates and epithelial instability. 27,28,31 With regards to corneal stroma, Rehany et al 32 observed that stromal keratocytes contain vacuoles of lipids and prominent endoplasmic reticulum, and in DM both stroma and Descemet's membrane are loaded with randomly distributed aggregates of normally spaced collagen fibrils.…”

Section: Tear Filmmentioning

confidence: 99%

Optical quality of the diabetic eye: a review

Calvo-Maroto

Pérez-Cambrodí²,

Albarán-Diego

et al. 2014

Eye

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Diabetes mellitus is a metabolic disorder characterized by the presence of chronic hyperglycaemia. Several structural, morphological, and physiological changes in each of ocular component have been described in detail during the past decades. Due to these abnormalities, the diabetic patient undergoes a degradation of the retinal image by an increase of higher ocular aberrations and ocular scattering coming from mainly tear film, cornea, and crystalline lens. This review aims to provide an overview of current knowledge about the effects of diabetes mellitus in these optical phenomena and its consequence on the visual quality of the diabetic patient.

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“…These changes include altered epithelial wound repair (Hatchell et al 1985;Awata et al 1988), increased epithelial fragility (O'Leary & Millodot 1981), recurrent epithelial erosions (Arentsen & Tasman 1981) and decreased corneal sensitivity (Macrae et al 1982).These data would suggest that diabetic keratopathy should be a significant clinical problem, particularly in diabetic contact lens wearing patients. Yet contact lens wear appears to produce minimal corneal complications in the well-controlled diabetic patient (Herse 1988). How can this discrepancy be explained?…”

Section: Iv) Clinical Relevancementioning

confidence: 99%

Oxygen consumption and ATPase activity in the corneal epithelium of rabbits with alloxan induced hyperglycemia

Herse¹,

Petchell²

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To more fully investigate the effect of hyperglycemia on the aerobic metabolism of the corneal epithelium. Methods: Corneal epithelial oxygen uptake rates and adenosine triphosphatase (ATPase) activities were measured in alloxan-induced diabetic and control rabbits over a 10 week period. Results: A transient reduction in epithelial oxygen uptake rate was seen at week 1. A chronic 14% reduction in oxygen consumption occurred after 6 weeks of hyperglycemia. Epithelial ouabain-sensitive ATPase activity was unaffected by 10 weeks of hyperglycemia. Epithelial ouabain-insensitive ATPase activity decreased 14% after 10 weeks of hyperglycemia. Conclusions: Ten weeks of hyperglycemia in the alloxan induced diabetic rabbit was associated with a 14% decrease in corneal oxygen uptake, a 14% decrease in corneal epithelial ouabain-insensitive ATPase activity and no change in corneal epithelial ouabain-sensitive ATPase activity. The Crabtree effect may help explain some of the clinical signs seen in the diabetic cornea as well as explaining why diabetic patients can wear contact lenses with minimal clinical problems.

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A Review of Manifestations of Diabetes Mellitus in the Anterior Eye and Cornea

Cited by 104 publications

References 0 publications

Blinking and superficial punctate keratopathy in patients with diabetes mellitus

Blinking and superficial punctate keratopathy in patients with diabetes mellitus

Optical quality of the diabetic eye: a review

Oxygen consumption and ATPase activity in the corneal epithelium of rabbits with alloxan induced hyperglycemia

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