Narooie-Noori Foroozan, Asharlous Amir, Mirzajani Ali, Jafarzadehpur Ebrahim, Behnia Mehdi, Khabazkhoob Mehdi
Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran 1968653111, Iran.
Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran 1968653111, Iran.
Int J Ophthalmol. 2023 Apr 18;16(4):571-578. doi: 10.18240/ijo.2023.04.11. eCollection 2023.
To compare anterior segment parameters between two groups of type 2 diabetic with and without diabetic retinopathy (DR) and non-diabetic elderly subjects based on hemoglobin A1c (HbA1c) levels and status of DR.
This study was conducted on 997 residents aged 60y or over in Tehran, Iran. Diabetic group had HbA1c level ≥6.4% with no other systemic problems. The non-diabetic participants had normal eye findings and no systemic diseases. K1, K2, mean K, Q-value, anterior, central, posterior, and total corneal densitometric findings, anterior chamber volume (ACV), anterior chamber depth (ACD), corneal volume (CV), and pachymetry were measured by Pentacam AXL.
A total of 678 non-diabetic (39% male) and 319 diabetic (35% male) subjects with mean age of 66.31±5.23 and 67.22±4.96y were examined, respectively. No statistically significant difference was found in anterior segment parameters between non-diabetic and diabetic groups (all >0.05). However, middle, posterior, and total corneal densitometric values were statistically different between two groups after controlling the effects of confounders (=0.014, 0.007, and 0.042, respectively). Corneal densitometric values in all layers, ACD, and ACV were different between diabetic subjects with and without DR (all <0.05). In the diabetic group, only corneal densitometric values had a negative relationship with fasting blood sugar (<0.001). ACD and ACV had a negative correlation with HbA1c levels (all <0.05, =-0.129 and -0.146, respectively). However, the relationships were not observed after controlling the confounders (=0.938, 0.466, respectively).
Considering the higher densitometric values of the cornea and lower ACD and ACV in diabetic subjects with DR, it is suggested that the examiners should perform comprehensive retinal examinations when faced with such conditions.
基于糖化血红蛋白（HbA1c）水平和糖尿病视网膜病变（DR）状态，比较两组2型糖尿病患者（有无DR）与非糖尿病老年受试者的眼前节参数。
本研究对伊朗德黑兰997名60岁及以上居民进行。糖尿病组HbA1c水平≥6.4%，无其他系统性问题。非糖尿病参与者眼部检查正常且无全身性疾病。使用Pentacam AXL测量K1、K2、平均K值、Q值、前、中、后及全角膜密度测量结果、前房容积（ACV）、前房深度（ACD）、角膜容积（CV）和角膜厚度。
分别检查了678名非糖尿病患者（男性占39%）和319名糖尿病患者（男性占35%），平均年龄分别为66.31±5.23岁和67.22±4.96岁。非糖尿病组和糖尿病组眼前节参数无统计学显著差异（均>0.05）。然而，在控制混杂因素影响后，两组的角膜中部、后部及全角膜密度测量值存在统计学差异（分别为=0.014、0.007和0.042）。有DR和无DR的糖尿病患者在各层角膜密度测量值、ACD和ACV方面均存在差异（均<0.05）。在糖尿病组中，仅角膜密度测量值与空腹血糖呈负相关（<0.001）。ACD和ACV与HbA1c水平呈负相关（均<0.05，分别为=-0.129和-0.146）。然而，在控制混杂因素后未观察到这种关系（分别为=0.938、0.466）。
鉴于有DR的糖尿病患者角膜密度值较高且ACD和ACV较低，建议检查人员在面对此类情况时应进行全面的视网膜检查。
