Department of Ophthalmology, INHS Jeevanti, Goa, India.
Department of Ophthalmology, INHS Asvini, Mumbai, India.
Rom J Ophthalmol. 2024 Apr-Jun;68(2):128-134. doi: 10.22336/rjo.2024.24.
To compare corneal parameters in diabetics versus age-group-matched non-diabetics; also, to correlate these parameters with the duration of diabetes, glycated haemoglobin (HbA1c) levels, and severity levels of diabetic retinopathy (DR). A comparative study was conducted at a tertiary eye-care center from January 2020 to December 2020. Two-hundred patients (400 eyes) with type-2 diabetes (100) and age-sex-matched non-diabetics (100) were included. Corneal morphological parameters like central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variance (CoV), hexagonality (6A), and average cell area were recorded by specular microscopy. These parameters were correlated with the duration of diabetes, severity of disease based upon fasting blood glucose levels, HbA1c, and grade of DR. Mean and standard deviation were calculated, and regular distribution of continuous data was tested using independent sample t-test and ANOVA. Mean ECD (2447.32 ± 269.89/mm2), 6A (45.03 ± 6.71%), and IOP (15.47 ± 2.02 mmHg) changed in diabetic cases and were significantly low in diabetics, whereas, mean average cell area (413 ± 50.19 mm2), standard deviation (167.05 ± 77.91), CCT (525.81 ± 36.69) and CoV (39.84 ± 15.59%), were significantly high in diabetics. Mean CCT had insignificant variation. Subgroup analysis within diabetics showed a statistically significant reduction of ECD, cell count, and 6A with increased duration of diabetes, poor glycaemic control, and raised HbA1c. The corneal endothelial analysis is vital in daily clinical practice and provides valuable evidence concerning the viability of corneal endothelium in various intraocular surgeries. Uncontrolled DM harms the cornea with 70% of diabetics resulting in complications like keratopathy. The study highlighted that the increased duration of diabetes raised HbA1c, and poor glycemic control negatively affected corneal morphology. Our study showed a definite reduction in ECD and 6A in diabetics compared to non-diabetics. A definite reduction in the corneal endothelial counts, cell density, and hexagonality was found in type-2 diabetics compared to non-diabetics. DM = Diabetes Mellitus, CCT = central corneal thickness, ECC = endothelial cell counts, ECD = endothelial cell density, CoV = coefficient of variance, 6A = hexagonality, DR = Diabetic retinopathy, SD = Standard of deviation, IOP = Intraocular pressure.
比较糖尿病患者与年龄匹配的非糖尿病患者的角膜参数;并将这些参数与糖尿病病程、糖化血红蛋白(HbA1c)水平和糖尿病视网膜病变(DR)严重程度相关联。
这是一项在 2020 年 1 月至 2020 年 12 月在三级眼科中心进行的病例对照研究。纳入了 100 例 2 型糖尿病患者(200 只眼)和 100 例年龄匹配的非糖尿病患者。通过共焦显微镜记录角膜形态学参数,如中央角膜厚度(CCT)、内皮细胞密度(ECD)、变异系数(CoV)、六边形(6A)和平均细胞面积。这些参数与糖尿病病程、基于空腹血糖水平的疾病严重程度、HbA1c 和 DR 分级相关联。计算平均值和标准差,并使用独立样本 t 检验和 ANOVA 检验连续数据的正态分布。
糖尿病患者的平均 ECD(2447.32±269.89/mm2)、6A(45.03±6.71%)和 IOP(15.47±2.02mmHg)发生变化,且显著低于糖尿病患者,而平均平均细胞面积(413±50.19mm2)、标准差(167.05±77.91)、CCT(525.81±36.69)和 CoV(39.84±15.59%)显著高于糖尿病患者。平均 CCT 无显著变化。糖尿病患者的亚组分析显示,随着糖尿病病程的延长、血糖控制不佳和 HbA1c 升高,ECD、细胞计数和 6A 均呈统计学显著降低。
角膜内皮分析在日常临床实践中至关重要,可为各种眼内手术中角膜内皮的活力提供有价值的证据。未控制的 DM 会损害角膜,70%的糖尿病患者会出现角膜病变等并发症。本研究表明,糖尿病病程延长、HbA1c 升高和血糖控制不佳对角膜形态有负面影响。与非糖尿病患者相比,我们的研究发现糖尿病患者的 ECD 和 6A 确实降低。与非糖尿病患者相比,2 型糖尿病患者的角膜内皮细胞计数、细胞密度和六边形明显减少。DM = 糖尿病,CCT = 中央角膜厚度,ECC = 内皮细胞计数,ECD = 内皮细胞密度,CoV = 变异系数,6A = 六边形,DR = 糖尿病视网膜病变,SD = 标准差,IOP = 眼内压。