July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Factors influencing corneal biomechanics in diabetes mellitus
Author Affiliations & Notes
  • Lisa Ramm
    University Hospital Carl Gustav Carus TU Dresden, Dresden, Germany
  • Robert Herber
    University Hospital Carl Gustav Carus TU Dresden, Dresden, Germany
  • Naim Terai
    University Hospital Carl Gustav Carus TU Dresden, Dresden, Germany
  • Lutz E Pillunat
    University Hospital Carl Gustav Carus TU Dresden, Dresden, Germany
  • Footnotes
    Commercial Relationships   Lisa Ramm, None; Robert Herber, None; Naim Terai, None; Lutz Pillunat, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6802. doi:
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      Lisa Ramm, Robert Herber, Naim Terai, Lutz E Pillunat; Factors influencing corneal biomechanics in diabetes mellitus. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6802.

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

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Purpose : Hyperglycemia in diabetes mellitus (DM) induces changes in corneal biomechanics. Therefore, biomechanical properties of the cornea were measured using the Ocular Response Analyzer (ORA) and the Corvis ST (CST) with the aim to identify factors influencing corneal biomechanics in DM.

Methods : 64 eyes of 64 diabetic patients were included. After an ophthalmological examination measurements with the ORA and the CST were done. Additionally, biometry and corneal topography were performed and information on DM duration, current therapy, ocular DM manifestations and HbA1c values were collected. Results were compared to an age-, pachymetry- and intraocular pressure (IOP)-matched group of 55 healthy subjects and the influence of disease specific factors on corneal biomechanical readings were analyzed.

Results : Mean age (68.2 ± 11.9 vs. 66.1 ± 10.1 years), IOP and central corneal thickness were not significantly different between the groups (p > 0.05). Mean HbA1c in patients was 7.3 ± 1.7 %. The Corneal Hysteresis (CH, 10.6 ± 1.9 vs. 9.8 ± 1.7 mmHg, p = 0.009) was significantly and the Corneal Resistance Factor (CRF, 10.7 ± 2 vs. 10 ± 1.7 mmHg, p = 0.065) was nearly significantly different between diabetic and healthy subjects. The CH was higher in type I than in type II diabetes (p = 0.041) and increased in patients with diabetic retinopathy compared to patients without retinal disease manifestation (p = 0.027). Also, most dynamic corneal response parameters measured by CST showed significant differences. The table presents a selection of parameters, which were used to generate a “DM-Index”. It had a sensitivity of 89.7 % and a specificity of 77.8 % and showed a significant association to DM duration (r = 0.342, p = 0.042).

Conclusions : In DM corneal biomechanical properties were altered compared to healthy subjects. These changes were associated to disease duration, DM type and retinal involvement in diabetic patients.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.



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