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印度中部一家三级护理医院中糖尿病患者和年龄匹配的非糖尿病患者的中央角膜厚度及内皮细胞变化

Central Corneal Thickness and Endothelial Cell Changes in Diabetics and Age-Matched Non-diabetics in a Tertiary Care Hospital in Central India.

作者信息

Daigavane Sachin, Mallareddy Vijaya

机构信息

Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Mar 30;16(3):e57234. doi: 10.7759/cureus.57234. eCollection 2024 Mar.

Abstract

Background Diabetes has become an epidemic, significantly impacting ocular health as one of its end-organ responses. Among the various ocular complications, alterations in corneal morphology stand out. Central corneal thickness (CCT) and endothelial cell function are vital parameters in assessing intraocular pressure, conducting pre-refractive surgery evaluations, and maintaining corneal transparency. Understanding these changes in diabetic individuals compared to non-diabetics is crucial for managing ocular health in this population. Aim and objective This study evaluates and compares CCT and endothelial cell changes between diabetic individuals and age-matched non-diabetics. By analyzing these parameters, the study seeks to provide insights into the impact of diabetes on corneal morphology and its implications for ocular health. Methods The study recruited 124 patients from the Ophthalmology Outpatient Department (OPD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi. A cross-sectional research design was employed to collect data over six months. Patients were carefully selected, and informed consent was obtained from all participants. CCT and endothelial cell parameters were assessed using specular microscopy, a non-invasive imaging technique. Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) for inferential statistics, such as t-tests and ANOVA, and comparing parameters between diabetic and non-diabetic groups. Findings were interpreted based on both statistical significance and clinical relevance. Results In diabetic patients, the mean CCT was 547.91 µm, while it was 523.62 µm in non-diabetic individuals. The T statistic for this variable was 5.14, indicating a  significant difference between the two groups. Similarly, significant differences were found between diabetics and non-diabetics for endothelial cell density, coefficient of variation, and hexagonality, as evidenced by their respective T statistics of 7.46, 5.17, and 4.91. Endothelial cell density averaged 2375 cells/mm in diabetics and 2666.95 cells/mm in non-diabetics. Additionally, the coefficient of variation was higher among people with diabetes (40.87%) compared to non-diabetics (35.09%). Hexagonality, a measure of endothelial cell shape, was lower in diabetic corneas (40.48%) than in non-diabetic corneas (46.46%). Conclusion The study observed significant differences in corneal morphology, including central thickness and endothelial cell changes, between diabetic and non-diabetic individuals. These findings underscore the impact of diabetes on ocular health and emphasize the importance of monitoring corneal parameters in diabetic patients. Understanding these changes can aid in better management and treatment strategies for ocular complications associated with diabetes.

摘要

背景 糖尿病已成为一种流行病,作为其终末器官反应之一,对眼部健康产生了重大影响。在各种眼部并发症中,角膜形态的改变尤为突出。中央角膜厚度(CCT)和内皮细胞功能是评估眼压、进行屈光手术前评估以及维持角膜透明度的重要参数。了解糖尿病患者与非糖尿病患者相比的这些变化,对于管理该人群的眼部健康至关重要。

目的 本研究评估并比较糖尿病患者与年龄匹配的非糖尿病患者的CCT和内皮细胞变化。通过分析这些参数,该研究旨在深入了解糖尿病对角膜形态的影响及其对眼部健康的意义。

方法 该研究从萨旺吉的阿查里亚·维诺巴·巴韦农村医院(AVBRH)眼科门诊招募了124名患者。采用横断面研究设计,在六个月内收集数据。患者经过精心挑选,并获得了所有参与者的知情同意。使用镜面显微镜这一非侵入性成像技术评估CCT和内皮细胞参数。使用社会科学统计软件包(SPSS)进行统计分析,以进行推断统计,如t检验和方差分析,并比较糖尿病组和非糖尿病组之间的参数。根据统计显著性和临床相关性对结果进行解释。

结果 在糖尿病患者中,平均CCT为547.91 µm,而非糖尿病个体为523.62 µm。该变量的T统计量为5.14,表明两组之间存在显著差异。同样,糖尿病患者和非糖尿病患者在内皮细胞密度、变异系数和六角形度方面也存在显著差异,其各自的T统计量分别为7.46、5.17和4.91,证明了这一点。糖尿病患者的内皮细胞密度平均为2375个细胞/mm,非糖尿病患者为2666.95个细胞/mm。此外,糖尿病患者的变异系数(40.87%)高于非糖尿病患者(35.09%)。作为内皮细胞形状的一种度量,六角形度在糖尿病角膜中(40.48%)低于非糖尿病角膜(46.46%)。

结论 该研究观察到糖尿病患者与非糖尿病患者在角膜形态方面存在显著差异,包括中央厚度和内皮细胞变化。这些发现强调了糖尿病对眼部健康的影响,并强调了监测糖尿病患者角膜参数的重要性。了解这些变化有助于更好地管理和治疗与糖尿病相关的眼部并发症。

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