Assessment of Corneal Endothelium among Diabetic Patients in a Multispecialty Hospital in Tamil Nadu
Introduction: Corneal damage is the common issue affecting 70% of diabetic patients. Diabetic cornea has functional abnormalities such as decreased corneal Endothelial Cell Density (ECD), thicker corneas with increased endothelial permeability, lesser corneal sensitivity, and elevated corneal a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/14177/44713_CE[Ra1]_F(KM)_PF1(AKA_KM)_GC(NS_SL)_PN(SL).pdf |
| Summary: | Introduction: Corneal damage is the common issue affecting
70% of diabetic patients. Diabetic cornea has functional
abnormalities such as decreased corneal Endothelial Cell
Density (ECD), thicker corneas with increased endothelial
permeability, lesser corneal sensitivity, and elevated corneal
auto-fluorescence.
Aim: To study the corneal endothelial characteristics among
diabetic patients and to identify the factors associated with
endothelial damage and compare the corneal changes based
on the duration of diabetes mellitus and glycaemic control.
Materials and Methods: The hospital based cross-sectional
study was conducted in 155 patients (100 diabetic and
55 control) from 24th September 2016 to 29th March 2018. The
corneal endothelial morphological features were evaluated
using a non-contact EM-3000 specular microscope. The
morphological characteristics of endothelial cell like the ECD,
Coefficient of Variation (CV), Central Corneal Thickness (CCT),
and percentage of hexagonal cells were compared between
diabetic patients and the control population. Age, gender,
blood pressure, duration of diabetes, fasting and Postprandial
Blood Sugar (PPBS) HbA1c value, blood urea, and serum
creatinine, Intra Ocular Pressure (IOP) were also recorded, and
the endothelial cell characteristics were compared between the
diabetic groups according to the duration (< or ≥ 3 years) and
HbA1c% (< or ≥ 7%). An independent t-test was performed
to compare the means of endothelial characteristics between
study subjects and the control group and also between duration
of diabetes and HbA1C levels. A p-value of less than 0.05 was
considered statistically significant. The data were analysed
using a SPSS statistical program.
Results: Baseline characteristics like Fasting Blood Sugar
(FBS), PPBS, HbA1c, Systolic and Diastolic Blood Pressure
(SBP and DBP) were significantly higher in diabetic group than
control. A significant difference in corneal thickness (p=0.01)
and hexagonality (p<0.001) were also observed between both
the groups. The diabetic group showed a reduction in cell
density and a higher coefficient variation of cell size however
the differences were not statistically significant, There was no
significant difference in the ECD, CCT, CV, and hexagonality
irrespective to HbA1c level and duration of diabetes.
Conclusion: Patients with diabetes had a significant increase
in corneal thickness, and a higher frequency of pleomorphism
compared to control subjects. In terms of ECD and co-efficient
variation, no difference was observed between groups. |
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| ISSN: | 2249-782X 0973-709X |