scholarly journals Corneal Endothelial Morphology in Children with Type 1 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Mohamed Anbar ◽  
Hatem Ammar ◽  
Ramadan A. Mahmoud

Aim. To investigate corneal endothelial cell morphological in children with type 1 diabetes and to determine the systemic and local factors that contribute to these changes.Methods. One hundred sixty eyes of 80 children with type 1 diabetes and 80 eyes of 40 normal children as a control during the period from July 2015 to February 2016 underwent full clinical and ophthalmologic examination. We measured the central corneal thickness (CCT), endothelial cell density (ECD), ploymegathism, and pleomorphism using a noncontact specular microscope.Results. The mean age of the diabetic children was8.22±3.11years. The mean duration of type 1 diabetes was3.51±2.23years. The mean CCT was significantly higher:537±33.41microns (right eye), in the diabetic group compared to the control group. The mean ECD in patients with type 1 diabetes was3149.84±343.75cells/mm2(right eye), and it was significantly lower than in the control group. Furthermore, pleomorphism was significantly lower48.73±5.43% (right eye), in the diabetic group compared to the control group. The mean polymegathism was significantly higher37.96±5.61% (right eye), in the diabetic group compared to the control group. All of these changes are significantly correlated only with the duration of diabetes.Conclusions. Diabetic children have thicker corneas, lower ECD, an increased polymegathism, and a decreased pleomorphism. The duration of diabetes is the factor that affects all of these changes. To what extent these changes affect visional function on long term needs to be investigated in further studies.

2018 ◽  
Vol 5 (3) ◽  
pp. 694 ◽  
Author(s):  
Nagaraj G. ◽  
Anasuya Sangaraj Desai ◽  
Nagesh Jayaram

Background: Diabetes mellitus is associated with structural changes in corneal endothelial cells and their thickness. The present study was done to compare the endothelial cell density (ECD), central corneal thickness (CCT) and morphology in diabetic and non-diabetic patients.Methods: A cross-sectional study was conducted at Minto Ophthalmic hospital, BMC and RI Bangalore for a period of 20 months (October 2013 - May 2015). A total of 200 study subjects, 100 diabetics and 100 non-diabetic age matched controls were selected, and complete timed ophthalmic evaluation was performed. Specular microscopy was performed on all patients for endothelial cell count assessment and corneal thickness was measured by Pachymeter. The data was analyzed and represented using descriptive statistics. ‘t’ test was used for comparing the two groups.Results: The mean endothelial cell density in diabetic group was significantly lower (2438.73±250.23cells/mm2) compared to non-diabetic group (2599.88±168.16cells/mm2) (p<0.0001). The mean Central corneal thickness in diabetic group was significantly higher (518.40±28.13 μm) compared to control group (490.14±24.31 μm) (p<0.001). The Co-efficient of variation percentage of the diabetics was higher than the non-diabetics but this difference was not statistically significant (P>0.05). The hexagonality percentage was significantly lower in diabetic group compared to the controls suggesting less pleomorphism in the diabetic group.Conclusions: The study concludes that the endothelial cell density was lower and central corneal thickness was higher in diabetic patients compared with the non-diabetics. The altered endothelial morphology was significantly seen in the form of pleomorphism (hexagonality) but polymegathism was not significantly altered.


Author(s):  
Soundaram Meenakshisundaram ◽  
Melina I Sahay ◽  
Damal Kandadai Sriram ◽  
Melvin George

Introduction: Corneal damage is the common issue affecting 70% of diabetic patients. Diabetic cornea has functional abnormalities such as decreased corneal Endothelial Cell Density (ECD), thicker corneas with increased endothelial permeability, lesser corneal sensitivity, and elevated corneal auto-fluorescence. Aim: To study the corneal endothelial characteristics among diabetic patients and to identify the factors associated with endothelial damage and compare the corneal changes based on the duration of diabetes mellitus and glycaemic control. Materials and Methods: The hospital based cross-sectional study was conducted in 155 patients (100 diabetic and 55 control) from 24th September 2016 to 29th March 2018. The corneal endothelial morphological features were evaluated using a non-contact EM-3000 specular microscope. The morphological characteristics of endothelial cell like the ECD, Coefficient of Variation (CV), Central Corneal Thickness (CCT), and percentage of hexagonal cells were compared between diabetic patients and the control population. Age, gender, blood pressure, duration of diabetes, fasting and Postprandial Blood Sugar (PPBS) HbA1c value, blood urea, and serum creatinine, Intra Ocular Pressure (IOP) were also recorded, and the endothelial cell characteristics were compared between the diabetic groups according to the duration (< or ≥ 3 years) and HbA1c% (< or ≥ 7%). An independent t-test was performed to compare the means of endothelial characteristics between study subjects and the control group and also between duration of diabetes and HbA1C levels. A p-value of less than 0.05 was considered statistically significant. The data were analysed using a SPSS statistical program. Results: Baseline characteristics like Fasting Blood Sugar (FBS), PPBS, HbA1c, Systolic and Diastolic Blood Pressure (SBP and DBP) were significantly higher in diabetic group than control. A significant difference in corneal thickness (p=0.01) and hexagonality (p<0.001) were also observed between both the groups. The diabetic group showed a reduction in cell density and a higher coefficient variation of cell size however the differences were not statistically significant, There was no significant difference in the ECD, CCT, CV, and hexagonality irrespective to HbA1c level and duration of diabetes. Conclusion: Patients with diabetes had a significant increase in corneal thickness, and a higher frequency of pleomorphism compared to control subjects. In terms of ECD and co-efficient variation, no difference was observed between groups.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Beata Urban ◽  
Dorota Raczyńska ◽  
Alina Bakunowicz-Łazarczyk ◽  
Krystyna Raczyńska ◽  
Małgorzata Krętowska

Purpose. To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients.Materials and Methods. The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the control group. The mean duration of diabetes was 8.02 ± 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P.Results. The mean ECD in diabetic eyes was 2435.55 ± 443.43 cells/mm2and was significantly lower than in control group (2970.75 ± 270.1 cells/mm2). The mean CCT was 0.55 ± 0.03 mm in diabetic group versus 0.53 ± 0.033 mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level.Conclusions. ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT.


2004 ◽  
Vol 61 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Zorica Milosevic ◽  
Jelica Bjekic ◽  
Stanko Radulovic ◽  
Branislav Goldner

Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient?s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%) in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by mammography could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Enrico Borrelli ◽  
Domenico Grosso ◽  
Mariacristina Parravano ◽  
Eliana Costanzo ◽  
Maria Brambati ◽  
...  

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.


2021 ◽  
pp. 1-5
Author(s):  
Mehmet Türe ◽  
Alper Akın ◽  
Edip Unal ◽  
Ahmet Kan ◽  
Suat Savaş

Abstract Background: Adult patients diagnosed with type 1 diabetes mellitus are at risk for ventricular arrhythmias and sudden cardiac death. Aim: The objective of our study is to evaluate the electrocardiographic data of children diagnosed with type 1 diabetes mellitus and to determine the possibility of arrhythmia in order to prevent sudden death. Methods: Electrocardiographic data of 60 patients diagnosed with type 1 diabetes mellitus and 86 controls, who were compatible with the patient group in terms of age and gender, were compared. Results: The duration of diabetes in our patients with type 1 diabetes mellitus was 5.23 ± 1.76 years, and the haemoglobin A1c levels were 9.63% ± 1.75%. The heart rate, QRS, QT maximum, QT dispersion, QTc minimum, QTc maximum, QTc dispersion, Tp-e maximum, Tp-e maximum/QTc maximum and the JTc were significantly higher compared to the control group. There was no significant correlation between the duration of type 1 diabetes mellitus and HbA1c levels and the electrocardiographic data. Conclusion: We attributed the lack of a significant correlation between the duration of type 1 diabetes mellitus and the haemoglobin A1c levels and the electrocardiographic data to the fact that the duration of diabetes was short, since our patients were children. We believe that patients with type 1 diabetes mellitus should be followed up closely in terms of sudden death, as they have electrocardiographic changes that may cause arrhythmias compared to the control group. However, more studies with longer follow-up periods are necessary to support our data.


2008 ◽  
Vol 18 (6) ◽  
pp. 581-585 ◽  
Author(s):  
Ebru Y. Imamoglu ◽  
Funda Oztunc ◽  
Ayse G. Eroglu ◽  
Hasan Onal ◽  
Alper Guzeltas

AbstractObjectiveWe aimed, in this study, to compare dispersion of the p wave in patients with type 1 diabetes to nondiabetic control subjects, and to investigate the relationship between the dispersion of the p wave and cardiac autonomic dysfunction in diabetic children.MethodsWe enrolled 49 patients with type 1 diabetes, and 32 age- and sex-matched healthy subjects, measuring the Valsalva ratio, resting heart rate, and orthostatic hypotension in all. The duration of the p wave was measured manually on a high-resolution computer screen. Dispersion, defined as the difference between maximum and minimum durations of the p waves, was also measured in the 12-lead electrocardiogram before and after the Valsalva maneuver.ResultsThe mean age of the patients and their controls were 14.2 ± 4.8 years, and 12.7 ± 4.5 years, respectively. The mean duration of diabetes had been 6.2 ± 4.6 years. Maximal and minimal values for the duration of the p wave were significantly decreased in the diabetic children, with the dispersion itself significantly increased. Values for the dispersion in the diabetic subjects were similar before and after the Valsalva maneuver, whereas dispersion was found significantly increased after this maneuver in the controls. The differences in the Valsalva ratio, resting heart rate, and orthostatic hypotension between the groups, on the other hand, were not found to be statistically significant.ConclusionThe noted increase in the dispersion of the p wave in diabetic children reveals the onset of cardiac electrophysiological heterogeneity before it is possible to detect parasympathetic and sympathetic dysfunction with other tests.


2020 ◽  
Author(s):  
Tae Gi Kim ◽  
Yoo Jin Kim

Abstract Aim of this study is to evaluate the differences in corneal endothelial cell morphology and corneal thickness in patients with and without type 2 diabetes related to age, disease duration, and HbA1c percentage. This retrospective cross-sectional study included 511 type 2 diabetes patients (1022 eyes) and 900 (1799 eyes) non-diabetic patients. The endothelial cell density (ECD), variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were analyzed using a noncontact specular microscope and a Pentacam Scheimpflug camera. We also examined the correlation between the corneal parameters and the duration of diabetes. Blood HbA1c results in DM patients were used within 2 months of ophthalmic examination. The controls had no diabetes confirmed by blood tests. For all ages, the subjects with type 2 diabetes showed significantly lower ECD, hexagonality, higher CV, and thicker CCT than the control group. This difference was more pronounced in patients with long-standing DM (≥10 years) and high HbA1c (≥7 %). When stratified by age group, from the 60s group, corneal endothelial cell parameters showed a statistically significant difference between DM and control groups. The duration of diabetes was inversely correlated with ECD (r=-0.167; P=0.000), but HbA1c was not correlated with ECD. These findings suggest that diabetes affects corneal endothelial cell in older age and those with long-standing DM and higher HbA1c. Regular corneal endothelial examinations are required in diabetic patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ying Xiao ◽  
Tao Li ◽  
Yan Jia ◽  
Shanshan Wang ◽  
Chenhao Yang ◽  
...  

Purpose. To compare ocular biometry between children with type 1 diabetes mellitus (T1DM) and healthy children in China and to determine the correlation of ocular biometry with the glycosylated hemoglobin (HbA1c) level and diabetes duration. Methods. A case-control study was conducted at Children’s Hospital of Fudan University between T1DM children and healthy children. The participants were evaluated for central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), K1 and K2 keratometry, and axial length (AL); also cycloplegic refraction was performed, and spherical equivalent (SE) was acquired. HbA1c levels of the T1DM cases were obtained. Results. Fifty-four eyes of 54 children with T1DM and 53 eyes of 53 healthy children were included. The mean age of T1DM group and control group was 10.59 ± 3.40 years and 9.55 ± 1.89 years, respectively, and the differences between age and gender were not significant (p=0.052, p=0.700). The mean LT in T1DM group (3.49 ± 0.18 mm) was thicker than that in the control group (3.40 ± 0.16 mm) (p=0.018), the mean ACD in T1DM group (3.52 ± 0.26 mm) was shallower than that in the control group (3.72 ± 0.26 mm) (p<0.001), and there were no significant differences of CCT, K1, K2, AL, and SE (p=0.088, p=0.672, p=0.821, p=0.094, and p=0.306, respectively). There was no significant correlation between HbA1c or diabetes duration and ocular biometry. Conclusions. Thicker LT and shallower ACD occurred in T1DM children rather than age-matched and sex-matched healthy children, but the overall refraction was not affected. HbA1c or diabetes duration was not correlated with ocular biometry in T1DM children.


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