Evaluation of the relationship between corneal biomechanic and HbA1C levels in type 2 diabetes patients

Yazgan, Serpil; Çelik, Uğur; Kaldırım, Havva; Ayar, Orhan; Elbay, Ahmet; Aykut,; Çelik, Burak; Taş, Mehmet

doi:10.2147/opth.s67984

Cited by 14 publications

(16 citation statements)

References 20 publications

(31 reference statements)

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“…Type 2 DM subjects also recorded significantly higher GAT measured-IOP, while ECDs were more significantly reduced than in healthy normal subjects ( Table 2 ). This finding is also consistent with previous reports on type 2 DM subjects [ 6 - 7 , 13 ] . Su et al [ 25 ] also observed that among Malays, those with diabetes and hyperglycemia showed significantly thicker central corneas, which were independent of age and IOP levels.…”

Section: Discussionsupporting

confidence: 94%

“…Similar to previous reports [ 7 , 22 ] , the present study found that IOP was not correlated with CCT, ECD (after correcting for age) or with duration of DM that included all diabetic subjects. Measured CCT, ECD and IOP on the same subjects based on duration of diabetes are reported only in our study.…”

Section: Discussionsupporting

confidence: 90%

“…Diabetic patients have higher IOP than nondiabetic patients [ 6 - 7 , 13 - 14 ] . High IOP and diabetes remain risk factors for glaucoma although some authors disagree [ 15 - 16 ] .…”

Section: Introductionmentioning

confidence: 99%

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Manifestations of type 2 diabetes in corneal endothelial cell density, corneal thickness and intraocular pressure

2016

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We sought to evaluate central corneal thickness (CCT), corneal endothelial cell density (ECD) and intraocular pressure (IOP) in patients with type 2 diabetes mellitus (DM) and to associate potential differences with diabetes duration and treatment modality in a prospective, randomized study. We measured ECD, CCT and IOP of 125 patients with type 2 DM (mean age 57.1±11.5 years) and compared them with 90 age-matched controls. Measured parameters were analyzed for association with diabetes duration and glucose control modalities (insulin injection or oral medication) while controlling for age. In the diabetic group, the mean ECD (2511±252 cells/mm2), mean CCT (539.7±33.6 µm) and mean IOP (18.3±2.5 mmHg) varied significantly from those the control group [ECD: 2713±132 cells/mm2 (P<0.0001), CCT: 525.0±45.3 µm (P=0.003) and IOP: 16.7±1.8 mmHg (P<0.0001)]. ECD was significantly reduced by about 32 cell/mm2 for diabetics with duration of >10 years when compared with those with duration of <10 years (P<0.05). CCT was thicker and IOP was higher for diabetics with duration of >10 years than those with duration of <10 years (P>0.05). None of the measured parameters was significantly associated with diabetes duration and treatment modality (P>0.05). In conclusion, subjects with type 2 DM exhibit significant changes in ECD, IOP and CCT, which, however, are not correlated with disease duration or if the patients receive on insulin injection or oral medications.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 90%

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Manifestations of type 2 diabetes in corneal endothelial cell density, corneal thickness and intraocular pressure

2016

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“… 9 , 12 , 18 A recent study comparing ORA data among 2 groups of diabetic patients (HbA1c <7%, HbA1c ≥7%) and healthy controls did demonstrate similar differential associations and found that IOPcc was not significantly different among the 3 groups, whereas IOPg was significantly higher in the diabetic patients than in the controls. 19 For smoking, findings have been variable, with some studies reporting no association 8 , 9 , 11 , 13 , 18 and other studies reporting higher IOP in smokers. 10 , 20 Among women, IOPg in this study was not significantly associated with smoking in univariable ( P = 0.004) or multiple regression ( P = 0.41, not shown in tables), a finding also seen in the Gutenberg Health Study using noncontact tonometry.…”

Section: Discussionmentioning

confidence: 99%

Associations with Intraocular Pressure in a Large Cohort

et al. 2016

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PurposeTo describe the associations of physical and demographic factors with Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) in a British cohort.DesignCross-sectional study within the UK Biobank, a large-scale multisite cohort study in the United Kingdom.ParticipantsWe included 110 573 participants from the UK Biobank with intraocular pressure (IOP) measurements available. Their mean age was 57 years (range, 40–69 years); 54% were women, and 90% were white.MethodsParticipants had 1 IOP measurement made on each eye using the Ocular Response Analyzer noncontact tonometer. Linear regression models were used to assess the associations of IOP with physical and demographic factors.Main Outcome MeasuresThe IOPg and IOPcc.ResultsThe mean IOPg was 15.72 mmHg (95% confidence interval [CI], 15.70–15.74 mmHg), and the mean IOPcc was 15.95 mmHg (15.92–15.97 mmHg). After adjusting for covariates, IOPg and IOPcc were both significantly associated with older age, male sex, higher systolic blood pressure (SBP), faster heart rate, greater myopia, self-reported glaucoma, and colder season (all P < 0.001). The strongest determinants of both IOPg and IOPcc were SBP (partial R2: IOPg 2.30%, IOPcc 2.26%), followed by refractive error (IOPg 0.60%, IOPcc 1.04%). The following variables had different directions of association with IOPg and IOPcc: height (−0.77 mmHg/m IOPg; 1.03 mmHg/m IOPcc), smoking (0.19 mmHg IOPg, −0.35 mmHg IOPcc), self-reported diabetes (0.41 mmHg IOPg, −0.05 mmHg IOPcc), and black ethnicity (−0.80 mmHg IOPg, 0.77 mmHg IOPcc). This suggests that height, smoking, diabetes, and ethnicity are related to corneal biomechanical properties. The increase in both IOPg and IOPcc with age was greatest among those of mixed ethnicities, followed by blacks and whites. The same set of covariates explained 7.4% of the variability of IOPcc but only 5.3% of the variability of IOPg.ConclusionsThis analysis of associations with IOP in a large cohort demonstrated that some variables clearly have different associations with IOPg and IOPcc, and that these 2 measurements may reflect different biological characteristics.

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“…Several studies have reported thickening of central corneal thickness (CCT) in people with diabetes [ 5 , 6 , 7 , 8 ]. The basis for the association is unknown but one of the postulation is hyperglycaemia may cause corneal endothelial dysfunction with resultant stromal hydration and swelling of the cornea with some suggesting that this may be one of the earliest changes detectable in the diabetic eye [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation of the anterior ocular segment biometry with HbA1c level in type 2 diabetes mellitus patients

2018

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ObjectivesTo compare the anterior ocular segment biometry among Type 2 diabetes mellitus (DM) with no diabetic retinopathy (DR) and non-proliferative diabetic retinopathy (NPDR), and to evaluate the correlation of anterior ocular segment biometry with HbA1c level.MethodsA cross-sectional study was conducted in Hospital Universiti Sains Malaysia, Kelantan from November 2013 till May 2016 among Type 2 DM patients (DM with no DR and DM with NPDR). The patients were evaluated for anterior ocular segment biometry [central corneal thickness (CCT), anterior chamber width (ACW), angle opening distance (AOD) and anterior chamber angle (ACA)] by using Anterior Segment Optical Coherence Tomography (AS-OCT). Three ml venous blood was taken for the measurement of HbA1c.ResultsA total of 150 patients were included in this study (DM with no DR: 50 patients, DM with NPDR: 50 patients, non DM: 50 patients as a control group). The mean CCT and ACW showed significant difference among the three groups (p < 0.001 and p = 0.015 respectively). Based on post hoc result, there were significant mean difference of CCT between non DM and DM with NPDR (mean difference 36.14 μm, p < 0.001) and also between non DM and DM with no DR (mean difference 31.48 μm, p = 0.003). The ACW was significantly narrower in DM with NPDR (11.39 mm SD 0.62) compared to DM with no DR (11.76 mm SD 0.53) (p = 0.012). There were no significant correlation between HbA1c and all the anterior ocular segment biometry.ConclusionDiabetic patients have significantly thicker CCT regardless of retinopathy status whereas ACW was significantly narrower in DM with NPDR group compared to DM with no DR. There was no significant correlations between HbA1c and all anterior ocular segment biometry in diabetic patients regardless of DR status.

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Evaluation of the relationship between corneal biomechanic and HbA1C levels in type 2 diabetes patients

Cited by 14 publications

References 20 publications

Manifestations of type 2 diabetes in corneal endothelial cell density, corneal thickness and intraocular pressure

Manifestations of type 2 diabetes in corneal endothelial cell density, corneal thickness and intraocular pressure

Associations with Intraocular Pressure in a Large Cohort

Correlation of the anterior ocular segment biometry with HbA1c level in type 2 diabetes mellitus patients

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