Purchase this article with an account.
Lisa Ramm, Robert Herber, Naim Terai, Lutz E Pillunat; Factors influencing corneal biomechanics in diabetes mellitus. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6802.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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).
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.
This PDF is available to Subscribers Only