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Allison Hinko, David Rogers, Nick F Fogt; Corneal endothelial parameters as biomarkers for diabetes in children. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1158.
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© ARVO (1962-2015); The Authors (2016-present)
To assess endothelial cell morphology in type I diabetics using a non-contact specular microscope and to compare the endothelial cell morphology to age-matched controls. To compare changes in endothelial cell morphology in type I diabetics to traditional measures of diabetic control.
A total of 25 diabetic children were recruited from the eye clinics at Nationwide Children's Hospital (NCH) from March 2012 to April 2014. Photographs of the corneal endothelium of each eye were obtained via the Konan SP-9000 non-contact specular microscope. The Konan KSS-300 software was then used to calculate endothelial parameters including the coefficient of variation (COV), percentage of hexagonal cells (%Hex) and the endothelial cell density (ECD). Comparisons of the mean values of endothelial parameters were made between diabetic and control groups. Correlations were made for the diabetic subjects between the COV and the duration since diagnosis, the %Hex versus the duration since diagnosis, the COV and the HbA1C, and the %Hex versus HbA1C.
There was no significant difference in the mean age of type I diabetic subjects (12.60 ± 3.44) versus that of the control group (11.74 ± 2.85). In the diabetic group, the mean corneal thickness (585.3 ± 27.7) and endothelial cell density (2945 ± 350) were not significantly different from those values of the control group (578 ± 43.1 and 3018 ± 322, respectively). There was, however, a significant difference between the 2 groups in regards to the COV and the %Hex. The COV in the diabetic group was 30.75 ± 4.77, which was significantly higher than that of the controls (25.05 ± 3.42). The %Hex in the diabetic group was (66.68 ± 8.14), which was significantly lower than that of the controls (72.24 ± 7.30). Within the diabetic group, there was no linear relationship between the COV or the %Hex and the HbA1C. There was, however, a moderate relationship between the COV and duration of diabetes as well as the %Hex and the duration of diabetes.
The results of this study suggest that in diabetic children the %Hex decreases. The COV was significantly higher in the diabetic group. The rest of the parameters were not significantly different. These data suggest that the corneal endothelium of diabetic children is morphologically different from that of non-diabetic children. The results demonstrated that the longer the duration of diabetes, the lower the %Hex and the higher the COV.
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