Variation of accommodative process and anterior chamber parameters in diabetic patients

Abstract

PurposeChronic hyperglycemia is responsible for vascular and neurodegenerative retinal changes in diabetic patients. However, other eye structures have been also associated with changes, such as corneal biomechanics and lens thickness.The author's objective was to analyze the accommodative process – crystalline structural change and pupillary diameter based on Anterior Segment Optical Coherence Tomography (AS‐OCT).MethodsProspective case‐control study. The anterior chamber parameters were studied using AS‐OCT. The monocular accommodative process was obtained with different Dioptric Powers (0 D, 2.5 D, 5 D and 7 D – lens integrated in the OCT software) in both controlled photopic and scotopic conditions. 2 groups have been analyzed: group 1 with type 2 diabetic patients and group 2 with healthy‐controls. Measurements of anterior chamber depth (ACD), lens vault (LV), pupillary diameter (PD) and iris thickness (IT) were obtained.ResultsA total of 71 patients were evaluated (group 1 − n = 36; group 2 – n = 35). The mean age was 69.15 ± 5.55 years. Diabetic patients have showed the basal highest LV and lowest ACD values, with statistically significance (p < 0.05). In highest accommodative power, group 2 has experimented a significant reduction in ACD, ACA and PD (p < 0.05). The LV change has not proved important in the process. Group 1 has showed a significant response in scotopic conditions, even with a lower response with the highest accommodative stimuli compared to group 2.ConclusionsThe accommodative process is impaired in diabetic patients, with a significant difference in pupillary response more than in lens vault. This could be important to explain the importance of the anterior segment of crystalline in accommodation. Further studies will be necessary to clarify the DM effects on these parameters.