The Cornea in Diabetes Mellitus

Hasan, S. Akbar

doi:10.1007/978-0-387-85900-2_12

Cited by 2 publications

(3 citation statements)

References 92 publications

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“…32,33 Peningkatan ekspresi matrix metaloproteinase (MMP) bersamaan dengan kerusakan barrier endotel akan merusak kolagen stromal, meningkatkan absorbsi cairan dan berdampak pada terjadinya penebalan stromal. 33,34 Penebalan membrana basalis epitel, terjadinya proses kompensasi polymorphism dan polymegantism pada endotel kornea serta penebalan stromal akan mengakibatkan peningkatan ketebalan sentral kornea (central corneal thickness / CCT). 32,35 Perbandingan derajat CCT terhadap derajat retinopati diabetik pada penelitian ini dapat dibuktikan dengan mengambil data dari beberapa penderita yang kedua matanya menjadi subyek sampel penelitian pada derajat retinopati yang berbeda.…”

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Perubahan Nilai Central Corneal Thickness Sebagai Deteksi Severitas Retinopati Diabetikum Pada Penderita Diabetes Melitus Tipe Ii

2021

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Hyperglycemia has a toxic effect on almost all cells in the body. Ocular complications due to hyperglycemia can occur in the cornea and retina. Retinal microvascular disorders in patients with type II DM are called diabetic retinopathy. Type II diabetes mellitus has a significant influence on the morphological, metabolic, physiological, and clinical aspects of the cornea that can be evaluated by measuring central corneal thickness (CCT) using Anterior Segment -Optical Coherence Tomography (AS-OCT). Morphological changes occur in corneal epithelium, epithelial basement membrane and basement, stromal and endothelial membrane complexes. CCT changes as changes in the retina of type II DM patients are chronic processes that lead to changes in the structure and biomechanics of the cornea and retina. Method: The subjects of this study consisted of 36 eyes of type II DM patients divided into 4 diabetic retinopathy groups (mild, moderate, severe NPDR and PDR) with GDS> 200mg / dl then CCT values were measured using thick (33.3%); thin (13.9%); ; very thick CCT (8.3%). There is no statistically significant relationship between the degree of CCT and severity of diabetic retinopathy. Conclusion: The CCT value of DM type II sufferers in the PDR group was higher than in the NPDR group, where there was an increase in CCT value along with an increase in severity of diabetic retinopathy, but the results were statistically not significant. CCT examination is expected to be one of the evaluations to evaluate the progression of hyperglycemic in type II DM against ocular disorders, especially cornea.

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Perubahan Nilai Central Corneal Thickness Sebagai Deteksi Severitas Retinopati Diabetikum Pada Penderita Diabetes Melitus Tipe Ii

2021

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“…It is well documented in the literature that both morphologic and functional corneal changes occur in patients with diabetes . This finding is evidenced clinically by the high prevalence of ocular surface disease, persistent or nonhealing epithelial defects, reduced tear secretion, reduced corneal sensitivity, and diabetic keratopathy, which is found in up to 50% of patients with diabetes .…”

Section: Introductionmentioning

confidence: 97%

“…It is well documented in the literature that both morphologic and functional corneal changes occur in patients with diabetes. [3][4][5][6][7][8] This finding is evidenced clinically by the high prevalence of ocular surface disease, persistent or nonhealing epithelial defects, reduced tear secretion, reduced corneal sensitivity, and diabetic keratopathy, which is found in up to 50% of patients with diabetes. [3][4][5] Rosenberg and colleagues 6 studied 44 eyes and found that patients with diabetes had reduced epithelial thickness, increased overall corneal thickness, and a reduction in nerve fiber bundles, suggesting a mechanism for diabetic epitheliopathy.…”

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Association Between Endothelial Cell Density and Transplant Suitability of Corneal Tissue With Type 1 and Type 2 Diabetes

et al. 2017

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The rate of types 1 and 2 diabetes in the United States is increasing. The effect of diabetes on corneal donor tissue is unknown.OBJECTIVES To determine the association between endothelial cell density and suitability for transplantation in cornea donors with type 1 or 2 diabetes and determine the effect of diabetes on technician-induced endothelial damage during cornea donor tissue processing. DESIGN, SETTING, AND PARTICIPANTS Donor information was obtained from the SightLife Eye Bank for donors from June 1, 2012, to June 30, 2015. The presence of diabetes was determined based on donor medical history. Severe diabetes was classified based on the presence of comorbidities of diabetes. The donor data set contained information on 34 497 donated eyes during the 3-year period, including donor demographics, time from death to refrigeration and preservation of the cornea, endothelial cell count, lens status, medical and surgical history, and suitability for transplantation. MAIN OUTCOMES AND MEASURES Endothelial cell density, suitability for transplantation based on tissue analysis, and technician-induced endothelial damage.RESULTS Among 14 532 donors (mean [SD] age, 58.6 [13.4] years; 8516 men and 6016 women), the mean (SD) endothelial cell count was 2732 (437) cells/mm 2 . Type 1 or 2 diabetes was listed in the medical history for 8552 of 27 948 donor eyes (30.6%); 5242 eyes (18.8%) were from patients with severe diabetes. After adjusting for age, race/ethnicity, sex, lens status, time from death to refrigeration, and time from death to preservation, the presence of diabetes (adjusted odds ratio, 0.79; 95% CI, 0.51-1.22; P = .28) and severe diabetes (adjusted odds ratio, 95% CI, 0.86; 95% CI, 0.54-1.39; P = .54) were not associated with poor transplant suitability based on results of tissue examination. Donors with diabetes (mean [SD] cell count difference, 9.0 [6.7] cells/mm 2 ; 95% CI, -4.1 to 22.2; P = .18) and severe diabetes (mean [SD] cell count difference, 7.7 [8.1] cells/mm 2 ; 95% CI, -8.1 to 23.6; P = .34) did not exhibit lower cell counts. Technician-induced endothelial damage occurred in 59 corneas (0.2%) but was not associated with the presence of diabetes (adjusted odds ratio, 1.23; 95% CI, 0.66-2.32; P = .52).CONCLUSIONS AND RELEVANCE These data suggest that cornea donors have a high frequency of diabetes. However, this analysis was not able to show that the presence of diabetes was associated with technician-induced endothelial damage, reduced transplant suitability, or reductions in endothelial cell counts. Eye banks may need to collect medical history in a more robust manner. Additional studies may be valuable to determine the effect on long-term transplant outcomes of diabetes in cornea donors.

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The Cornea in Diabetes Mellitus

Cited by 2 publications

References 92 publications

Perubahan Nilai Central Corneal Thickness Sebagai Deteksi Severitas Retinopati Diabetikum Pada Penderita Diabetes Melitus Tipe Ii

Perubahan Nilai Central Corneal Thickness Sebagai Deteksi Severitas Retinopati Diabetikum Pada Penderita Diabetes Melitus Tipe Ii

Association Between Endothelial Cell Density and Transplant Suitability of Corneal Tissue With Type 1 and Type 2 Diabetes

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