Comparison of Anterior Segment Parameters in Juvenile Diabetes Mellitus and Healthy Eyes

Abstract

Juvenile DM may affect anterior segment parameters and cause thicker LT, smaller PD, and lower AD. These effects may change the refractive status and should be considered during the examination of these children.

Influence of Type 1 Diabetes Mellitus on the Ocular Biometry of Chinese Children

“…The present study showed that the LT was significantly larger accompanied by the ACD decrease than that of the healthy children, which agree with the findings of Uzel et al [8]. A previous study of internal structure of lens performed with corrected Scheimpflug imaging by Wiemer et al [9] found that the lens was consisted of three cortical zones and the nucleus; in T1DM patients, all four layers rather than one typical layer of the lens were significantly thicker compared with those of the healthy control subjects, which supports the hypothesis that the thickening of the lens is the result of cellular or extracellular overhydration rather than insulin-induced mitogenesis of the epithelial cells.…”

“…It was noteworthy that despite LT and ACD significantly changed in T1DM children, no relation was found between the blood HbA1c level or DM duration and LT, ACD, and the other unchanged parameters (AL, SE, K1, K2, and CCT). Our study was in agreement with Uzel et al's [8], who found no relationship between LT and the HbA1c level in T1DM children. Several other studies have investigated the effect of DM duration or HbA1c level on ocular parameters.…”

“…For example, Suraida et al [12] found that there was significant mean difference of CCT between non-DM and DM with nonproliferative diabetic retinopathy (NPDR) or no DR in T2DM patients; the NPDR group showed the highest CCT of 529.26 μ m, then 524.60 μ m for the no DR group, and 493.12 μ m for the non-DM group. It differed from the study by Uzel et al, who found patients with juvenile DM had similar CCT, K1, and K2 compared to age- and sex-matched healthy children, the mean CCT value was 542.95 μ m and 541.38 μ m, respectively [8]. To concur with that, Wiemer et al [13] measured CCT from 102 patients with T1DM, 101 patients with T2DM, and 69 healthy subjects, and the mean CCT was 0.578 mm, 0.586 mm, and 0.578 mm respectively; no statistically significant difference was found between the 3 groups, whilst the anterior radius and overall corneal power did not differ significantly except for the posterior corneal radii between the 3 groups.…”

“…So, the lens becomes rounder rather than larger in T1DM patients. The aforementioned authors also reported a ACD decrease accompanied by the LT grew [6, 8, 10].…”

An Update on Corneal Biomechanics and Architecture in Diabetes

“…These results are comparable to those from a similar study conducted in Turkey by Akinci et al [96]. However, other studies have not found this increase in CCT in children or young people with T1D [97, 98]. In another Turkish study in children with T1D, CCT was not shown to be associated with either the current fasting glucose level or duration of disease [99].…”