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Yicheng Chen, Patrick Gore, Mitchell D McCartney, David C Gritz, Prajbot Channa; Endothelial Cell Density in Diabetic and Non-diabetic Corneas: A Retrospective Eye Bank Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1157. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
There is conflicting evidence regarding the effect of diabetes mellitus on the corneal endothelium. One hypothesis is that oxidative and osmotic stress from excessive activation of the polyol pathway and accumulation of sorbitol may contribute to corneal endothelial damage in patients with diabetes mellitus. In order to better understand the relationship between diabetes and corneal endothelial cell changes, we performed a retrospective study comparing endothelial cell density in diabetic and non-diabetic corneas from an eye bank database.
De-identified cornea donor data from July 2013 to June 2014 was supplied by the Lions Eye Institute for Transplant and Research. Pseudophakic donors were excluded from the study. Diabetic and non-diabetic donors were distinguished based upon medical history as well as medication lists. Statistical analysis was performed using two-tailed Mann-Whitney U tests.
A total of 1486 diabetic corneas and 2488 non-diabetic corneas were analyzed. The mean age of the diabetic group was 57.27 and the mean age of the non-diabetic group was 53.23. The median endothelial cell density was 2566 cells/mm2 and 2608 cells/mm2 respectively. The U was 1728931 and the p-value was statistically significant at 0.0006. When the data was stratified by age into 0-20, 21-30, 31-40, 41-50, 51-60, 61-70, and 71-80 age groups, the difference between the two populations was no longer statistically significant with p-values of 0.365, 0.100, 0.283, 0.518, 0.067, 0.576, and 0.331.
Although initial analysis indicated a statistically significant difference in endothelial cell density between diabetic and non-diabetic corneas, age-stratified groups did not reveal a statistically significant difference. The discrepancy between the overall results and the age-stratified results may be due to a different distribution of ages between the diabetic and non-diabetic groups. The aldose reductase pathway may contribute to corneal endothelial changes in diabetes, but the results of this study suggest that endothelial cell density is not significantly affected. However, other measures of endothelial cell health such as pleomorphism and polymegathism may differ between diabetics and non-diabetics.
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