Comparison of corneal morphological characteristics between diabetic and non diabetic population

Islam, Qamar Ul; Mehboob, Mohammad Asim; Amin, Zulfiqar Ali

doi:10.12669/pjms.336.13628

Cited by 21 publications

(25 citation statements)

References 19 publications

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“…Our findings regarding ECD de- crease were in accordance with the majority of previous studies. Specifically, Inoue et al [11] found a 4.1% reduction in ECD in patients with DM compared to controls in line with other authors, who also reported a significant reduction in ECD in diabetic patients [9,10,[14][15][16][17][18][19][20]. However, there is no absolute consensus in the literature.…”

Section: Discussionmentioning

confidence: 76%

The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

et al. 2020

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Purpose: The aim of this study was to evaluate the characteristics of corneal endothelial cells and central corneal thickness (CCT) in patients with diabetes mellitus (DM), comparing them with those of healthy subjects (controls) and to determine potential factors affecting the corneal parameters in patients with DM. Methods: Participants in this study were 72 patients with DM and 88 healthy controls. Diabetic patients were further classified into groups depending on the severity of diabetic retinopathy (no retinopathy, mild, moderate, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy). All participants underwent non-contact specular microscopy to evaluate corneal endothelium parameters and CCT, while factors affecting endothelial cell density and CCT in patients with DM were also analyzed. Results: Patients with DM presented significantly decreased endothelial cell density compared to controls (2,297.9 ± 311.3 and 2,518.3 ± 243.7 cells/mm², respectively; p < 0.001), while the two groups did not differ significantly in any other measured corneal parameter. In the diabetic group, the multivariate analysis showed a significant association between decreased endothelial cell density and increased HbA1c (p < 0.001), longer DM duration (p = 0.003), and more severe diabetic retinopathy status (p = 0.008). Conclusion: DM seems to affect the corneal endothelium, since endothelial cell density was decreased in the diabetic group, while duration of disease, HbA1c levels, and severity of retinopathy were significantly associated with changes in endothelial cell density and should be taken into account.

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Section: Discussionmentioning

confidence: 76%

The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

et al. 2020

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“…Calvo-Maroto et al [139] studied the effect of diabetes duration and poor glycemic control on the endothelial cell population: they found that the longer the evolution time of diabetes, the greater the loss of endothelial cells; this could be the reason why we find more differences in T1D patients, who are generally of a younger age at disease onset and usually present a longer duration of diabetes evolution. Islam et al [138], Anbar et al [136], and Urban et al [133] also found this correlation between diabetes duration and ECD.…”

Section: Diabetes and Endotheliummentioning

confidence: 79%

“…Regarding endothelial characteristics, diabetes patients seem to have higher rates of polymegathism and lower percentages of hexagonality (higher polymorphism) [79, 131, 136, 137]. Moreover, Anbar et al [136] and Islam et al [138] found a significant correlation between the duration of diabetes and pleomorphism and polymegathism, supporting the idea that the longer the disease evolution, the more the endothelial alteration.…”

Section: Diabetes and Endotheliummentioning

confidence: 97%

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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“…In a population-based cross-sectional study, Sudhir et al [20] reported that ECD was significantly lower in diabetic patients than in controls, but there was no significant difference between groups regarding hexagonality % or CV of cell size. Islam QU et al [21] reported that the mean ECD was significantly lower in diabetic patients than in agematched healthy controls, but the mean average cell size, CV and hexagonality were not significantly different between the two groups. Similar to our results, the duration of diabetes was significantly correlated with ECD and hexagonality.…”

Section: Discussionmentioning

confidence: 96%

The findings of corneal specular microscopy in patients with type-2 diabetes mellitus

et al. 2020

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Background: We aimed to compare the morphological characteristics of corneal endothelial cells in type 2 diabetic patients and age-matched healthy subjects by specular microscopy. We also aimed to determine the association of corneal morphological features with the general characteristics and laboratory data of diabetic patients, including disease duration, haemoglobin A1c (HbA1c) levels and urine albumin creatinine ratio. Methods: A total of 195 diabetic patients and 100 healthy controls were enrolled in the study. All participants underwent a complete ophthalmological examination. Corneal endothelial measurements were performed using a noncontact specular microscopy. Laboratory data including serum fasting glucose, haemoglobin A1c levels, creatinine levels, and the urinary albumin-to-creatinine ratio were recorded. Diabetic patients were further subdivided into 3 groups according to the presence and stage of diabetic retinopathy. Specular microscopy findings and central corneal thickness of all patients were compared. Results: The ECD and hexagonal cell ratio were significantly lower, while the average cell size, CV%, and central corneal thickness were determined to be significantly higher in diabetic patients than in healthy controls (p = 0.001). With the presence and advancement of diabetic retinopathy, the ECD and hexagonal cell ratio decreased, while the average cell size, CV%, and central corneal thickness increased. When correlation analysis was performed between corneal morphological features and laboratory data of diabetic patients, ECD showed a significant negative correlation with diabetes duration (p = 0.028). HbA1c levels, urinary albumin-creatinine ratio (p = 0.041), average cell size and CV showed a positive correlation with these parameters. Conclusion: In conclusion, keratopathy is an important complication of type 2 diabetes. With an increase in the stage of diabetic retinopathy, alterations in corneal findings also increased. In that respect, we can suggest that keratopathy should be evaluated more cautiously in diabetic patients.

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Comparison of corneal morphological characteristics between diabetic and non diabetic population

Cited by 21 publications

References 19 publications

The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

An Update on Corneal Biomechanics and Architecture in Diabetes

The findings of corneal specular microscopy in patients with type-2 diabetes mellitus

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