Department of Ophthalmology, University Hospital Dresden , Dresden, Germany.
Curr Eye Res. 2020 Oct;45(10):1228-1234. doi: 10.1080/02713683.2020.1741009. Epub 2020 Mar 17.
: To investigate the influence of chronic hyperglycemia in diabetes mellitus (DM) on spatial corneal thickness distribution and to analyze the influence of disease-specific factors. : DM patients and healthy subjects were matched according to age and intraocular pressure (IOP). In diabetics, disease duration, DM type, and HbA value were assessed. Spatially resolved corneal thickness was measured by Pentacam HR. Thinnest corneal thickness (TCT) and peripheral pachymetry of concentric circles around TCT were determined. The Dynamic Scheimpflug Analyzer Corvis ST (CST) was used to measure the parameter pachy slope, which is an indicator of the change of corneal thickness from the apex to the periphery. : 59 DM patients and 57 healthy subjects were included. Age ( = .486) and IOP ( = .154) were not different between the groups. In DM, pachy slope was significantly higher than in healthy subjects (41.1 ± 9.87 vs. 35.18 ± 10.64 μm, = .004). Also, the differences between TCT and the average of peripheral corneal thickness of concentric circles with a diameter of 2 mm (10.3 ± 1.7 vs. 9.3 ± 3.8 μm, < .001) to 6 mm (82.2 ± 12.4 vs. 76.8 ± 12.6 μm, = .011) were increased in patients. Changes in thickness profile were associated with HbA value and presence of diabetic retinopathy or maculopathy. : In DM, a stronger peripheral corneal thickness increase was detectable. This change was shown using the novel CST parameter pachy slope and confirmed by Pentacam readings. These alterations might affect IOP and biomechanical measurements, and influence refractive procedures.
: 目的:探讨糖尿病(DM)患者慢性高血糖对角膜厚度空间分布的影响,并分析其与疾病相关因素的关系。 : 方法:根据年龄和眼内压(IOP),对 DM 患者和健康受试者进行匹配。在糖尿病患者中,评估疾病持续时间、DM 类型和 HbA 值。通过 Pentacam HR 测量角膜厚度的空间分辨率。确定最薄角膜厚度(TCT)和 TCT 周围同心环的周边角膜厚度。使用动态 Scheimpflug 分析仪 Corvis ST(CST)测量角膜厚度从顶点到周边的变化指标 pachy slope。 : 结果:共纳入 59 例 DM 患者和 57 例健康对照者。两组年龄( = 0.486)和 IOP( = 0.154)无差异。DM 患者的 pachy slope 明显高于健康对照组(41.1 ± 9.87 比 35.18 ± 10.64 μm, = 0.004)。此外,TCT 与 2mm(10.3 ± 1.7 比 9.3 ± 3.8 μm, < 0.001)至 6mm(82.2 ± 12.4 比 76.8 ± 12.6 μm, = 0.011)的周边角膜厚度平均值之间的差异在患者中增加。厚度分布的变化与 HbA 值以及糖尿病视网膜病变或黄斑病变的存在有关。 : 结论:在 DM 中,可检测到更明显的周边角膜厚度增加。这种变化通过 CST 的新型 pachy slope 参数得到证实,并通过 Pentacam 读数得到确认。这些改变可能会影响眼压和生物力学测量值,并影响屈光手术。