July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Changes in Corneal Endothelial Morphology Over Four Years In Subjects With Type 2 Diabetes: A population-based study
Author Affiliations & Notes
  • Sangeetha Srinivasan
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Vikas Khetan
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Vaitheeswaran Kulothungan
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Rupak Roy
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Suganeswari Ganesan
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Tarun Sharma
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Rajiv Raman
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Footnotes
    Commercial Relationships   Sangeetha Srinivasan, None; Vikas Khetan, None; Vaitheeswaran Kulothungan, None; Rupak Roy, None; Suganeswari Ganesan, None; Tarun Sharma, None; Rajiv Raman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2890. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Sangeetha Srinivasan, Vikas Khetan, Vaitheeswaran Kulothungan, Rupak Roy, Suganeswari Ganesan, Tarun Sharma, Rajiv Raman; Changes in Corneal Endothelial Morphology Over Four Years In Subjects With Type 2 Diabetes: A population-based study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2890.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : There is lack of knowledge regarding longitudinal changes in the corneal endothelium in individuals with diabetes. The primary aim of the study was to examine the changes in the integrity of the corneal endothelium over four years in subjects with type 2 diabetes.

Methods : Patients were recruited from Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetic Study, a population-based follow-up study; 726 phakic subjects with a confirmed diagnosis of diabetes, with no corneal abnormalities/uveitis/glaucoma, and with no history of ocular surgeries, were examined once at baseline and after four years. Corneal endothelial hexagonality (HE%) (a measure of cell shape), coefficient of variation (CV%) (a measure of cell size) and central corneal thickness (CCT) were assessed in right eyes using noncontact specular microscopy and ultrasound pachymetry, respectively. Secondary analysis included univariate and step-wise multiple regression for assessing various clinical and biochemical factors associated with the change in corneal parameters over four years.

Results : The mean CV of cell size was higher (35.49 vs. 36.58, p<0.001) and HE was lower at follow-up (56.20 vs 53.82, p<0.001) when compared with baseline. The difference in mean cell density (-8.01, p=0.523) and CCT (1.41, p=0.091) from baseline to follow-up was not significant. An increase in the vibration perception threshold in the distal leg (a measure of severity of peripheral neuropathy) over four years was associated with a decrease in HE (p=0.018) when adjusted for age, sex, diabetes duration, history of smoking and alcohol intake, insulin use, presence of diabetic retinopathy at baseline, and changes in HbA1c levels, refractive error, axial length, blood pressure, and serum lipid levels. Changes in CV was not associated with any of the variables examined.

Conclusions : Small but significant corneal endothelial abnormalities in cell size and shape are evident in subjects with type 2 diabetes over four years. These abnormalities appear to be largely related to increasing severity of neuropathy, independent of age, diabetes duration, glycemic levels or diabetic retinopathy. The clinical significance of these findings necessitates further investigation.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×