Central Corneal Thickness Increase Due to Stromal Thickening With Diabetic Peripheral Neuropathy Severity

Kumar, Navasuja; Pop‐Busui, Rodica; Musch, David C.; Reed, David; Momont, Anna C.; Hussain, Munira; Raval, Nilesh; Moroi, Sayoko E.; Shtein, Roni M.

doi:10.1097/ico.0000000000001668

Cited by 23 publications

(23 citation statements)

References 35 publications

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“…Santiagu et al [86] found that diabetes during pregnancy also does not seem to influence CCT. In a recent article, Kumar et al [87] showed that CCT increases in relation to the severity of peripheral diabetic neuropathy due to an increase in stromal thickness. Other studies, however, have not found an increase in CCT in cases of T1D [88] or T2D patients [89–91].…”

Section: Diabetes and Corneal Stromamentioning

confidence: 99%

An Update on Corneal Biomechanics and Architecture in Diabetes

Buey

Casas

Caramello

et al. 2019

Journal of Ophthalmology

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In the last decade, we have witnessed substantial progress in our understanding of corneal biomechanics and architecture. It is well known that diabetes is a systemic metabolic disease that causes chronic progressive damage in the main organs of the human body, including the eyeball. Although the main and most widely recognized ocular effect of diabetes is on the retina, the structure of the cornea (the outermost and transparent tissue of the eye) can also be affected by the poor glycemic control characterizing diabetes. The different corneal structures (epithelium, stroma, and endothelium) are affected by specific complications of diabetes. The development of new noninvasive diagnostic technologies has provided a better understanding of corneal tissue modifications. The objective of this review is to describe the advances in the knowledge of the corneal alterations that diabetes can induce.

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Section: Diabetes and Corneal Stromamentioning

confidence: 99%

An Update on Corneal Biomechanics and Architecture in Diabetes

Buey

Casas

Caramello

et al. 2019

Journal of Ophthalmology

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“…A relationship between the cornea thickening and the increase in distal latency or a conduction velocity decrease both in motor and sensory fibers of the selected nerves was observed. So far, an association between CCT increase and diabetic peripheral neuropathy severity only in the adults with type 1 and type 2 diabetes has been described [21]. The authors demonstrated the increase in CCT values and referred it to the results of stromal thickening obtained by using the corneal confocal microscopy [21].…”

Section: Discussionmentioning

confidence: 97%

“…So far, an association between CCT increase and diabetic peripheral neuropathy severity only in the adults with type 1 and type 2 diabetes has been described [21]. The authors demonstrated the increase in CCT values and referred it to the results of stromal thickening obtained by using the corneal confocal microscopy [21]. The CCM method was already confirmed to be an effective and repeatable evaluation of diabetic neuropathy [22][23][24].…”

Section: Discussionmentioning

confidence: 97%

Central Corneal Thickness can be Related to Diabetic Peripheral Neuropathy in Children with Type 1 Diabetes

Jeziorny

Fila

Pyziak-Skupień

et al. 2019

Exp Clin Endocrinol Diabetes

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Aims Diabetic eye disease with its various manifestations as well as diabetic neuropathy may occur in patients with type 1 diabetes (T1D) after several years of diabetes duration. Pachymetry is a promising method evaluating central corneal thickness (CCT) in diabetic patients. The aim of the study was to evaluate the CCT values in children with T1D and its relationship to neurophysiological markers of diabetic neuropathy. Methods The study groups included 119 T1D children with average 5.3 years of diabetes duration and 38 age-matched controls. CCT index was measured with pachymeter in all subjects and in 19/119 of T1D patients the CCT values were referred to the ENG-EMG-SSR study results. Results In T1D patients the higher CCT values were observed as compared to healthy controls (p=0.037). Correlations between CCT values and both distal latency of the motor fibers of the median nerve (R=0.51; p=0.044) and conduction velocity of this nerve (R=−0.55; p=0.027) were noted. A conduction velocity of the sensory fibers of sural nerve correlated negatively with CCT index (R=−0.50; p=0.045) in the T1D patients. Conclusions CCT measurement may be helpful in the referral of the asymptomatic pediatric T1D patients to assess an early stage of diabetic neuropathy.

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“…A study utilizing a rabbit model of alloxan-induced diabetes showed that elevated glucose for 8 weeks leads to significant increases in intraocular pressure, corneal thickness, and stiffness [79]. In human studies, DM resulted in a significant increase in corneal thickness by as much as 19% compared to non-DM controls with cases of neuropathy or elevated HbA 1C showing the highest change in thickness [80,81,82], though others have reported no significant difference in corneal thickness in DM [83,84]. Moreover, biomechanical changes in the cornea as a result of DM have shown conflicting results.…”

Section: Effects Of Dm and Kc On Corneal Structurementioning

confidence: 99%

Mechanisms of Collagen Crosslinking in Diabetes and Keratoconus

McKay

Priyadarsini

Karamichos

2019

Cells

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Collagen crosslinking provides the mechanical strength required for physiological maintenance of the extracellular matrix in most tissues in the human body, including the cornea. Aging and diabetes mellitus (DM) are processes that are both associated with increased collagen crosslinking that leads to increased corneal rigidity. By contrast, keratoconus (KC) is a corneal thinning disease associated with decreased mechanical stiffness leading to ectasia of the central cornea. Studies have suggested that crosslinking mediated by reactive advanced glycation end products during DM may protect the cornea from KC development. Parallel to this hypothesis, riboflavin-mediated photoreactive corneal crosslinking has been proposed as a therapeutic option to halt the progression of corneal thinning by inducing intra- and intermolecular crosslink formation within the collagen fibrils of the stroma, leading to stabilization of the disease. Here, we review the pathobiology of DM and KC in the context of corneal structure, the epidemiology behind the inverse correlation of DM and KC development, and the chemical mechanisms of lysyl oxidase-mediated crosslinking, advanced glycation end product-mediated crosslinking, and photoreactive riboflavin-mediated corneal crosslinking. The goal of this review is to define the biological and chemical pathways important in physiological and pathological processes related to collagen crosslinking in DM and KC.

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Central Corneal Thickness Increase Due to Stromal Thickening With Diabetic Peripheral Neuropathy Severity

Cited by 23 publications

References 35 publications

An Update on Corneal Biomechanics and Architecture in Diabetes

An Update on Corneal Biomechanics and Architecture in Diabetes

Central Corneal Thickness can be Related to Diabetic Peripheral Neuropathy in Children with Type 1 Diabetes

Mechanisms of Collagen Crosslinking in Diabetes and Keratoconus

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