Department of Ophthalmology, Hindu Rao Hospital, New Delhi, India.
Department of Medicine, Hindu Rao Hospital, New Delhi, India.
Indian J Ophthalmol. 2021 Jul;69(7):1718-1724. doi: 10.4103/ijo.IJO_3120_20.
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.
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.
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.
Our study showed that poorly controlled patients with T2DM and those with macroalbuminuria have corneal endothelial abnormalities.
本研究旨在观察 2 型糖尿病(T2DM)患者的角膜内皮形态和厚度,并与年龄和性别相匹配的非糖尿病对照者进行比较。
本研究为在一家三级医院的眼科进行的基于医院的横断面观察性研究,共纳入 262 名患者(131 名 T2DM 患者为病例组,131 名无糖尿病患者为对照组)。所有患者均接受全面的眼科检查,包括视力、裂隙灯生物显微镜检查、眼压测量。比较病例组和对照组的中央角膜厚度(CCT)、内皮细胞密度(ECD)、变异系数(CV)和六边形细胞百分比(HEX)。分析角膜内皮功能障碍的预测因素。数据分析采用社会科学统计软件包(SPSS)版本 17.0。采用卡方检验、Fisher 确切检验和 Spearman 相关分析。
T2DM 患者的视力较差,眼压较高。与对照组相比,T2DM 患者的 CCT 较厚,ECD 较低,HEX 减少,CV 较高,但差异无统计学意义。HbA1c 水平与 CCT 和 CV 呈显著正相关,与 ECD 呈显著负相关。T2DM 患者的大量白蛋白尿和更高的白蛋白/肌酐比值与 CV 增加相关。
我们的研究表明,血糖控制不佳的 T2DM 患者和存在大量白蛋白尿的患者存在角膜内皮异常。