Effect of microalbuminuria on corneal endothelium in patients with diabetes without retinopathy

Corneal endothelial cell morphology and optical coherence tomography findings in children with type 1 diabetes mellitus

Purpose

To evaluate central macular thickness, retinal nerve fibre layer thickness, corneal endothelial cell density and central corneal thickness in children with Type 1 Diabetes Mellitus (DM).

Methods

Thirty children with Type 1 DM and 30 age-matched children as controls were examined. Central macular thickness (CMT) and four quadrants of retinal nerve fibre layer thickness (RNFLT) were measured by optical coherence tomography (OCT), while endothelial cell density (ECD), coefficient of variation in cell size (CV), hexagonality (HEX) and central corneal thickness (CCT) were measured by noncontact specular microscopy.

Results

The mean ECD was 2810.77  ±  273.47 cells/mm2 and the mean hexagonality ratio was 49.77  ±  13.2 both were significantly lower (p < 0.001, p  =  0.037 respectively) in the diabetic group compared to the control group. The mean CV was 37.6  ±  7.27, it was significantly higher (p  =  0.024) in the diabetic group than the control group. The mean corneal thickness was greater in the DM group than the controls, but the difference was not significant (p  =  0.176). There were no significant differences in CMT or RNFLT between the two groups. There was a negative correlation between the HbA1c levels and the thickness of the superior quadrants of RNFL (r  =  -0.406, p  =  0.026). The duration of diabetes had no significant correlations with the corneal and retinal parameters.

Conclusion

The diabetic children had changes in corneal endothelial morphology and there was a negative correlation between HbA1c levels and superior quadrant of RNFLT.

Corneal endothelial morphology and central corneal thickness in type 2 diabetes mellitus patients

Purpose

This study aimed to examine the corneal endothelial morphology and thickness in patients with Type 2 diabetes mellitus (T2DM) and compare them with age and sex-matched nondiabetic controls.

Methods

This hospital-based cross-sectional observational study was conducted in the ophthalmology department of a tertiary hospital consisting of 262 patients (131 with T2DM as cases and 131 without diabetes who served as controls). All patients underwent a comprehensive ocular examination including visual acuity, slit-lamp biomicroscopy, intraocular pressure measurement. Central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variance (CV), and percentage of hexagonal cells (HEX) were compared between the cases and controls. Predictors of corneal endothelial dysfunctions were analyzed. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 17.0. Chi-square test, Fisher's exact test, and Spearman's rho correlation analysis were used as appropriate.

Results

Patients with T2DM showed poorer visual acuity and higher intraocular pressure. As compared to controls, patients with T2DM had thicker CCT, lesser ECD, decreased HEX, and higher CV but the differences were statistically nonsignificant. HbA1c levels showed a significant positive correlation with CCT and CV and a negative correlation with ECD. Macroalbuminuria and higher albumin creatinine ratio was associated with an increase in CV in patients with T2DM.

Conclusion

Our study showed that poorly controlled patients with T2DM and those with macroalbuminuria have corneal endothelial abnormalities.

Effects of diabetes duration and HgA1C level on corneal endothelial morphology

OBJECTIVE

The aim of this study is to investigate the effects of the HbA1c level and the duration of diabetes mellitus on the corneal endothelium morphology and to compare between healthy individuals and diabetes mellitus patients with non-proliferative diabetic retinopathy and proliferative diabetic retinopathy.

MATERIAL AND METHODS

Ninety patients who applied to the Health Sciences University Ulucanlar Eye Training and Research Hospital between January 2016 and January 2017 were included in this prospective randomized study. In the study, 45 diabetes mellitus patients and 45 healthy individuals were evaluated. The diabetes patients were compared in terms of HbA1c level, diabetes mellitus duration, corneal endothelial cell density, coefficient of variation, standard deviation, and hexagonality with healthy control group.

RESULTS

A statistically significant difference was found in the endothelial cell densitometer, coefficient of variation, and standard deviation measurements between the diabetes mellitus patients and the control (healthy) group. But, there was no statistically significant difference between 6A (hexagonality) and central corneal thickness measurements. There was a negative correlation between HbA1c levels and diabetes mellitus times and endothelial cell densitometer values in the patients with diabetes mellitus diagnosis and standard deviation values in the positive direction. There was a statistically significant difference between diabetes mellitus patients with the diagnosis of non-proliferative diabetic retinopathy and proliferative diabetic retinopathy in the endothelial cell densitometer and standard deviation values. But there was not any statistically significant difference between coefficient of variation, 6A, and central corneal thickness values.

CONCLUSION

The endothelial cell densitometer in diabetes mellitus patients with retinopathy is lower than that in healthy individuals. There is a negative correlation between retinopathy severity and corneal endothelial cell density. Diabetes affects negatively not only vascular tissues but also avascular cornea.