Evaluation of Corneal Structure and Endothelial Morphological Characteristics in Type 2 Diabetic and Non-Diabetic Patients
Received 6 April 2020
Accepted for publication 2 July 2020
Published 14 July 2020 Volume 2020:14 Pages 1993—1999
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
João N Beato,1,2 João Esteves-Leandro,1 David Reis,3 Manuel Falcão,1,2 Vítor Rosas,1 Ângela Carneiro,1,2 Fernando Falcão Reis1,2
1Department of Ophthalmology, São João Hospital, Porto, Portugal; 2Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; 3Faculty of Medicine, University of Porto, Porto, Portugal
Correspondence: João N Beato
Department of Ophthalmology, São João Hospital, Al Prof Hernâni Monteiro, Porto 4200-319, Portugal
Tel +351 225 51 2168
Fax +351 225 51 3669
Purpose: To compare corneal structure and endothelial morphological features between patients with type 2 diabetes mellitus (DM) and non-diabetic patients; and determine if the DM duration, glycated hemoglobin (HbA1c) levels, and diabetic retinopathy (DR) stage affect corneal morphological properties.
Patients and Methods: Sixty diabetic patients and 47 age- and sex-matched controls were enrolled in this cross-sectional study. DM group was analyzed according disease duration, HbA1c levels, and presence of retinopathy. Endothelial cell density (ECD) and morphology (average and coefficient of variation [CV] of cell size, percentage of hexagonal cells) were recorded using non-contact specular microscopy. Central corneal thickness (CCT) and corneal volume were measured by scheimpflug tomography. Univariate and multivariate linear regression analyses were performed to evaluate the relationship between demographical, clinical, and ocular variables with CCT and ECD.
Results: There were no statistically significant differences in the endothelium cell density or morphology between DM and non-DM groups (p> 0.05). Also, there was no statistical difference between groups for CCT or corneal volume (p> 0.05). Multivariate linear regression analysis showed that older age (p=0.028) was significantly associated with lower ECD; CCT was found to be significantly greater in males (p< 0.001) and positively associated with corneal volume (p< 0.001).
Conclusion: The present study did not find any statistically significant differences between the corneal structural and endothelial characteristics of diabetic and non-diabetic subjects; other demographical parameters, such as age and gender, seem to be more determinant for the corneal properties.
Keywords: diabetes mellitus, endothelium, central corneal thickness
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