Title: Alteration of Corneal Structure in Patients with Diabetes Mellitus
Authors: Vineetha Prakasam, Chitra Raghavan, Beena Thankappan
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.190
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.
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