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Lydia Mineeva, Irina Slezkina; A Study of the Eye Dynamics and Vision in Patients with Diabetes Mellitus Type 2 and their Relationship with Blood Glucose Levels. Invest. Ophthalmol. Vis. Sci. 2013;54(15):809.
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© ARVO (1962-2015); The Authors (2016-present)
To study the dynamics of the eye and vision of patients with Diabetes Mellitus (DM) type 2 who are using insulin, in the subcompensation phase, and its relationship with blood glucose levels and glycated hemoglobin (HbA1c).
The sample consisted of 32 patients (84.4% females and 15.6% males) with DM type 2 without severe complications of diabetes and concomitant eye pathology. Ophthalmologic monitoring lasted for 2 years and insulin treatment duration was 5 years. The levels of blood sugar and HbA1c were regularly determined. In all patients visometry (by ESV-3000 ETDRS), biomicroscopy, autorefractometry, ophthalmoscopy, pneumotonometry (for P0), ultrasound biometry and pachymetry were performed. Lens opacity was graded by LOCS III system.
Subjective visual acuity in dynamics slightly reduced: from vis OD=3.9±0.5/9.1 ±7.8; vis OS=3.9±0.5/8.8±7.1 to vis OD=3.8±0.7/10.2±10; vis OS=3.8±0.7/9.9±9.2, however, this decrease was not statistically significant. The anterior part of the eye was without peculiar features, but destructive changes were found in the vitreous body which increased from 58% to 80%. The retina condition remained stable without negative dynamics in the form of non-proliferative stage of diabetic retinopathy. Blood sugar significantly decreased from 9.48±2.9 mmol/L to 7.9±2.2 mmol/L (p=0.02), and the level of HbA1c remained almost constant: 8.7±0.86% at the beginning and 8.54±0.91% at the end of the study (p<0.05). The opacity of lens (nuclear opalescence (NO)) significantly (p=0.03) improved (from 2.01±0,43 to 1.71±0.44), but the opacity of cortical cataract (C) declined (from 1.2±0.9 to 1.35±1.01). Nuclear color (NC) and posterior subcapsular cataract (P) remained unchanged. We found that the lens thickness increased with age (Spearman R=0.54, p=0.001); the thicker central optical zone of cornea led to the higher IOP (Spearman R=0.53, p=0.001).
The lens indicators NO and then C are primarily correlated with the development of diabetic cataract for the patients with DM using insulin. With the normalization of blood glucose diabetic retinopathy does not progress, NO indicators of lens can be improved but values of NC and P are not changed. Normalization of blood glucose levels does not stop the existing changes in the index C lens and the state of the vitreous body.
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