Evaluation of central corneal epithelial thickness with anterior segment OCT in patients with type 2 diabetes mellitus

Abstract

Aim: The aim of this study was to evaluate the central corneal thickness (CCT) and central corneal epithelial thickness (CCET) in patients with Type 2 diabetes mellitus (DM), and the effect of the duration of diabetes, the degree of diabetic retinopathy (DR), and HbA1c level.Method: CCT and CCET values of 72 patients diagnosed with type 2 DM and 72 healthy individuals were measured by anterior segment optical coherence tomography (AS-OCT). The eye tear function was evaluated with the Tear Break-up Time test (TBUT) and the Schirmer test. From the results of fundus examination, the diabetic patients were grouped as those without DR, with non-proliferative DR, and with proliferative DR. The disease duration and the HbA1c levels were recorded.Results: In the diabetic patients, the mean CCT was determined to be thicker (p=0.025), the CCET was thinner (p=0.003), and the TBUT and Schirmer values were lower (p<0.001, p<0.001, respectively). The duration of diabetes and the HbA1c level were not found to have any statistically signi cant effect on these parameters (p>0.05). The presence of retinopathy had no signi cant effect on CCT, TBUT and Schirmer values. The CCET was determined to be thinner in patients with retinopathy (p<0.001). Conclusion:As the corneal epithelial thickness is reduced in patients with advanced diabetic retinopathy, corneal epithelial pathologies can be seen more often. Therefore, early and effective treatment can be started taking into consideration the complications which may develop associated with the corneal epithelium following surgical procedures, especially those applied to the cornea.

Corneal Epithelial Changes in Diabetic Patients: A Review

“…The average duration of diabetes among these patients was 5.84 ± 4.32 years. One could argue that the diabetes population in this study was shifted towards good glycemic control and a relatively short overall duration of disease, as opposed to the group in the previous study (Yusufoğlu et al [ 7 ]) where the diabetic group had a longer mean duration of disease and higher mean HbA1c levels.…”

“…In another investigation conducted by Yusufoğlu et al, it was revealed that individuals with diabetes exhibited a higher mean CCT than those in the control group ( p = 0.025). However, CCET was lower in the diabetic group ( p = 0.003) [ 7 ]. Their study involved 72 eyes of 72 patients diagnosed with type 2 diabetes, alongside a control group of 72 healthy individuals.…”

Anterior Segment Ocular Coherence Tomography (as-oct) Based Central Corneal Epithelial Thickness (Ccet) as a Potential Biomarker for Diabetic Keratopathy: an Observational Study on Diabetic Patients in North India

“…We assume that, as such, the test is associated with low reliability and reproducibility. [33] The epithelial layer is a vital part of the cornea as it is exposed to environmental insults. Corneal epithelial pathologies may be seen more commonly in patients with advanced diabetic retinopathy due to decreased corneal epithelial thickness.…”

Diabetic Retinopathy: Soluble and Imaging Ocular Biomarkers

“…Studies with AS-OCT described an increased CCT in diabetic patients compared to controls (Table 2) [86][87][88]. It is worth noting that CCT measurements using AS-OCT may be higher than those obtained with slit-scanning topography and ultrasonic pachymetry [88].…”

“…Yusufo glu et al [87] showed an average percentage increase in CCT of about 2% in patients with DM compared to healthy controls and a reduction in the central corneal epithelial thickness (CCET) in diabetic patients with DR compared to those without DR (Table 2). In particular, CCET may decrease due to dry eye [89], impaired epithelial homeostasis associated with corneal neuropathy, and/or the effect of retinal photocoagulation [90].…”