Structural and Functional Studies of the Corneal Endothelium in Diabetes Mellitus

Keoleian, Gary M.; Pach, John M.; Hodge, David O.; Trocmé, Stefan D.; Bourne, William M.

doi:10.1016/s0002-9394(14)75755-1

Cited by 91 publications

(63 citation statements)

References 32 publications

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“…16 In contrast, some authors reported no significant difference in CCT when compared diabetic and non-diabetic eyes. [14][15][16][17][18][19] In our study, we showed that CCT of patients who had uncontrolled type II DM for over 5 years and HbA1c levels were over 7.9% for minimum 12 months; were significantly higher than non-diabetic healthy eyes. Some authors showed that there is no correlation between duration of DM and CCT.…”

Section: Discussionmentioning

confidence: 87%

Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Mete¹,

Kimyon²,

Çeri³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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ype II diabetes mellitus (DM) has become worldwide epidemic. By 2025, it is estimated that global prevalence will be approximately 380 million for type 2 DM.1,2 It is a chronic metabolic disease characterized by hyperglycaemia and affects the corneal epithelium, epithelial basement membrane complexes, stroma and endothelial cells. [3][4][5] Investigators showed that diabetes causes corneal morphology and endothelium abnormalities and it may cause physiological instability in In this prospective comparative-observational study, we investigated right eyes of 40 patients (40 eyes) with uncontrolled type 2 DM as study group and right eyes of 43 healthy control subjects (43 eyes). Central corneal thickness (CCT) and corneal endothelial parameters including endothelial cell density (ECD), coefficient of variation of cell area (CV) and percentage of hexagonal cells were examined using non-contact specular microscopy. All obtained data were compared statistically between groups. R Re es su ul lt ts s: : The study group had significantly increased mean CCT and reduced mean ECD values when compared with control group. The diabetic corneas also had higher percentage of CV in cell size and lower percentage of hexagonal cells than the control group, but the difference was not statistically significant. C Co on nc cl lu us si io on n: : The CCT was increased and ECD was reduced significantly in uncontrolled type II DM patients. This study also demonstrated that study group had higher percentage of CV in cell size and had lower percentage of hexagonal cells. K Ke ey yw wo or rd ds s: : Corneal endothelium; central corneal thickness; uncontrolled type II diabetes; specular microscopy Ö ÖZ ZE ET T A Am ma aç ç: : Kontrolsüz tip 2 diabetes mellitus (DM) hastalarında ve sağlıklı gönüllülerde santral kornea kalınlığı (SKK) ve kornea endotel parametrelerinin karşılaştırılması. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif karşılaştırmalı-gözlemsel çalışmada kontrolsüz tip 2 DM'si olan 40 hastanın sağ gözü (40 göz) ve 43 sağlıklı gönüllünün sağ gözü (43 göz) incelendi. Santral kornea kalınlığı (SKK) ve endotel hücre yoğunluğu (EHY), hücre alanı varyasyon katsayısı ve hekzagonalite yüzdesini içeren kornea endotel parametreleri temassız speküler mikroskop ile değerlendirildi. Elde edilen veriler iki grup arasında istatistiksel olarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : Kontrol grubu ile kıyaslandığında çalışma grubunun ortalama SKK'ı anlamlı olarak artmış, ortalama EHY'si anlamlı olarak azalmıştı. Kontrolsüz diyabetli grupta hücre alanı varyasyon katsayısı daha yüksekti ve hekzagonalite yüzdesi daha düşüktü fakat istatistiksel olarak anlamlı fark tespit edilmedi. S So on nu uç ç: : Kontrolsüz tip 2 DM'li hastalarda SKK anlamlı olarak artmış ve EHY anlamlı olarak azalmıştır. Çalışmamızda DM'li grupta daha yüksek oranda hücre alanı varyasyon katsayısı ve daha düşük oranda hekzagonal hücre izlenmiştir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Kornea endoteli; santral kornea kalınlığı; kontrols...

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Section: Discussionmentioning

confidence: 87%

Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Mete¹,

Kimyon²,

Çeri³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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“…However, they found altered morphology of the endothelium among diabetics (16). Likewise, Inoue et al and Wiemer et al did not report any differences in CCT between diabetics and controls (17,18).…”

Section: Discussionmentioning

confidence: 87%

Central corneal thickness in type II diabetes mellitus: is it relatedto the severity of diabetic retinopathy?

Toygar¹,

Pelit²,

Toygar³

et al. 2015

Turk J Med Sci

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Background/aim: To compare the central corneal thickness (CCT) of type II diabetes mellitus patients with age-and sex-matched healthy subjects and to determine the association of the severity of diabetic retinopathy and CCT. Materials and methods:Type II diabetes mellitus patients without retinopathy, with nonproliferative retinopathy, and with proliferative retinopathy were organized as the three subgroups of the study group, and an age-and sex-matched control group was formed. All subjects underwent full ophthalmological examination and CCT measurement with ultrasonographic pachymetry. CCT values were compared between diabetic and healthy subjects and between the three diabetic subgroups. Correlation analysis was performed to determine any relationship between CCT and intraocular pressure. Results:The average CCT was significantly higher in diabetic patients than in the control group (P = 0.04). CCT in diabetic patients without retinopathy did not significantly differ from that of patients with retinopathy (P = 0.64). Similarly, there was no significant difference in CCT between nonproliferative and proliferative diabetic retinopathy patients (P = 0.47). In the whole study population, CCT was significantly correlated with intraocular pressure (P < 0.01). Conclusion:CCT is significantly increased in type II diabetes mellitus patients with respect to controls. Retinal disease severity does not seem to have an effect on corneal thickness.

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“…Structural changes in the endothelium have been reported in patients with diabetes (25,26). In corneas of patients with diabetes, decreased sensation, neurotrophic ulceration, delayed wound healing, recurrent erosions, and epithelial edema have been found clinically.…”

Section: Discussionmentioning

confidence: 99%

Corneal Advanced Glycation End Products Increase in Patients With Proliferative Diabetic Retinopathy

et al. 2001

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OBJECTIVE—To evaluate corneal advanced glycation end product (AGE) fluorescence in patients with diabetes and in healthy control subjects. RESEARCH DESIGN AND METHODS—Corneal autofluorescence was measured in 26 eyes of 26 patients with type 2 diabetes (mean age 57.0 years; mean disease duration 12.2 years; mean HbA1c 7.1%) and 13 eyes of 13 healthy age-matched control subjects (mean age 57.9 years). The patients with type 2 diabetes were divided into the following groups: patients without diabetic retinopathy (DR), patients without proliferative diabetic retinopathy (PDR), and patients with PDR. Corneal autofluorescence was measured by fluorophotometry with the wavelength that is characteristic of AGE fluorescence (excitation and emission 360–370 nm and 430–450 nm, respectively). We defined peak corneal autofluorescence levels as corneal AGE fluorescence values. We compared the corneal AGE fluorescence values in the four groups. RESULTS—In the PDR group (11.9 ± 3.9 arbitrary units [mean ± SD]), the corneal AGE fluorescence values were significantly higher compared with the control subjects (6.9 ± 1.3 arbitrary units), the patients without DR (7.4 ± 2.1 arbitrary units), and the patients without PDR (6.9 ± 2.2 arbitrary units) (P < 0.05). CONCLUSIONS—We found that corneal AGEs may increase in patients with diabetes and PDR compared with control subjects, patients without DR, and patients without PDR. In the patients with PDR, increased corneal AGEs may play a role in diabetic keratopathy.

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Structural and Functional Studies of the Corneal Endothelium in Diabetes Mellitus

Cited by 91 publications

References 32 publications

Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Corneal Endothelial and Central Corneal Thickness Changes in Patients with Uncontrolled Type II Diabetes Mellitus

Central corneal thickness in type II diabetes mellitus: is it relatedto the severity of diabetic retinopathy?

Corneal Advanced Glycation End Products Increase in Patients With Proliferative Diabetic Retinopathy

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