Abstract
Objective: To determine the alteration in corneal characteristics such as endothelial cell density, mean cell area, coefficient of variation in cell size, hexagonality percentage and central corneal thickness in diabetic patients by comparing with a non diabetic group in a tertiary care hospital in South India
Methods: A cross sectional study was done including 190 diabetic patients and 190 non diabetic subjects in the age group of 40-70 years enrolled over a period of 1 year. Demographic data was collected and specular microscopy and pachymetry was done for all the subjects. The corneal parameters were compared in the 2 groups using independent samples t test.
Results: The mean age in the diabetic group was 57.91 and non diabetic group was 56.09. The mean values of mean cell area (437.17±134.32 and 394.11±143.68) coefficient of variation in cell size (28.02±9.94 and 22.68±6.09) were significantly higher in diabetic group compared to the non diabetic group. Hexagonality percentage was significantly lower in the diabetic group (55.46±19.65) compared to non diabetic group (75.94±6.48). Among the diabetic population, duration of diabetes had significant correlation with central corneal thickness (r=+0.190) and HbA1c levels had significant negative correlation with endothelial cell density and hexagonality (r=-0.318 and r=-0.239 respectively).
Conclusions: Endothelial cell morphology was found to be altered in patients with diabetes compared to non diabetic subjects which was associated with duration of disease and glycemic control in diabetic patients. This may have implications in the careful selection and intraoperative precautions in patients undergoing intraocular procedures.
Keywords-endothelial cell, corneal morphology, specular microscopy, diabetes.
References
- International Diabetes Federation Diabetes atlas, fifth ed. 2011.
- Kathryn Skarbez, Yos Priestley, Marcia Hoepf, Steven B. Koevar. Comprehensive review of the effects of Diabetes on Ocular Health; Expert Rev Ophthalmol. 2010 Aug 1; 5(4): 557–577.
- Rowe N, Mitchell P, Cumming RG, Wang JJ. Diabetes, fasting blood glucose and age-related cataract: the Blue Mountains Eye Study. Ophthalmic Epidemiology. 2000;7(2): 103–114.
- Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010 Jan. 33 Suppl 1:S62-9.
- Grading Diabetic Retinopathy from Stereoscopic Color Fundus Photographs—An Extension of the Modified Airlie House Classification: ETDRS Report Number 10. Ophthalmology; Volume 98, Issue 5, Supplement, May 1991, Pages 786-806.
- Choo M, Prakash K, Samsudin A, Soong T, Ramli N, Kadir A; Corneal chang-es in type II diabetes mellitus in Malaysia. Int J Ophthalmol. 2010;3(3):234-6.
- Sudhir RR, Raman R, Sharma T;Changes in the Corneal Endothelial Cell Density and Morphology in Patients With Type 2 Diabetes Mellitus: a Population-Based Study, SankaraNethralaya Diabetic Retinopathy And Molecular Genetics Study (SN-DREAMS, Report 23)..Cornea. 2012 Oct;31(10):1119-22
- Inoue K, Kato S, Inoue Y, Amano S, Oshika T; The corneal endothelium and thickness in type II diabetes mellitus.Jpn J Ophthalmol.2002 Jan-Feb;46(1):65-9.
- Ozdamar Y, Cankaya B, Ozalp S, Acaroglu G, Karakaya J, Ozkan SS; Is there a correlation between diabetes mellitus and central corneal thickness? J Glaucoma. 2010 Dec;19(9):613-6
- N Busted, T Olsen, and O Schmitz; Clinical observations on the corneal thickness and the corneal endothelium in diabetes mellitus.Br J Ophthalmol. 1981 October; 65(10): 687-690.
- Lee JS, Oum BS, Choie HY, et al: Differen-ces in corneal thickness and corneal endothelium related to duration in diabetes. Eye 2006; 20:315-318.
- Storr-Paulsen A, Singh A, Jeppesen H, Norregaard JC, Thulesen J; Corneal endothelial morphology and central thickness in patients with type II diabetes mellitus.2014 Mar;92(2): 158-60.
- Gautam Kukadia, Dr. Rupam Janak Desai, Dr. Jigisha Randeri, Dr. Om Prakash Billore, Dr. Pravin Jain, Dr. Rashmita Kukaoia ; To evaluate The Effect of Diabetes on The Central Corneal Thickness and Endothelial Cell Count ; AIOC 2009 Proceedings.
Corresponding Author
Chitra Raghavan
Associate Professor, Regional Institute of Ophthalmology, Trivandrum, Kerala, India
Phone : 9387803234, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.190
