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Karim Mohamed-Noriega, Gerardo Gonzalez-Saldivar, José Gerardo González-González, René Rodriguez-Gutiérrez, Jibran Mohamed-Noriega, Humberto Cavazos, Gerardo Villarreal Méndez, JESUS HERNAN GONZALEZ, Edgar Eliezer Cuervo-Lozano, Jesus Mohamed-Hamsho; Changes in visual function, ocular biometry and dry eye in naïve diabetic patients after euglycemic control. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3969.
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© ARVO (1962-2015); The Authors (2016-present)
Fluctuating blurred vision in uncontrolled diabetics is attributed to hyperglycemia-related reversible changes on the lens. We hypostatized that several ocular biometric changes might be implicated. We performed a prospective, observational, clinical study in uncontrolled naïve type-2 diabetics to correlate changes in visual function with refractive error, ocular biometry and dry eye after euglycemic control.
We included 38 eyes of 19 subjects with plasma glucose≥200mg/dl, Hba1c 7.5-10%. Evaluations were at baseline and 12 weeks after diet and metformin 850mg daily. All patients achieved stable euglycemic control (HbA1c≤7% & glucose<130mg/dl) after 12 weeks. Mean±SD age was 44±9 years, male:female distribution was 14:24. Patients with any disease, medication, surgery or history that might affect the evaluations were excluded. Evaluation includes: Uncorrected and best-corrected visual acuity (UCVA, BCVA), Pelli-Robson contrast sensitivity (CS), spherical equivalent (SE), tear osmolarity (Osm), Schirmer (ST), tear break-up time (TBUT), central corneal thickness (CCT), thinnest corneal pachymetry (pachy-thin), keratometry (K1, K2 & Km), anterior chamber (AC) depth, angle and volume, cornea and lens densitometry and endothelial specular microscopy . Outcomes are shown as mean±SD.
After week-12 HbA1c improved from 9.7±2.0 to 6.9±1.0 (p=0.000). The CS improved from 1.64±0.2 to 1.71±0.16 (p=0.049). Keratometries (K1, K2 and Km) showed steepening from 42.9±0.9 to 43.1±0.9 (p=0.037), 43.6±0.8 to 43.7±0.9 (p=0.012) and 43.2±0.8 to43.4±0.8 (p=0.004) respectively. Pachy-thin and CCC reduced from 542±31 to 538±35 (p= 0.048) and 542±31 to 536±30 (p= 0.007) respectively. Coefficient of variation of endothelium reduced from 37±6 to 35±5 (p=0.011). The AC angle increased from 34.27± 4.3 to 1.38±3.7 (p=0.35). The following showed no significant changes (p>0.05): UCVA, BCVA, SE, all dry eye parameters (Osm, TBUT & ST), Kmax, endothelial cell density, percentage of hexagonally, AC volume, AC depth, lens density, cornea density.
We found that several significant changes taking place in the ocular biometrics and cornea that improves CS and these findings may participate in the perception of visual improvements that diabetic patients have after glycemic control.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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