Relationship of Central Corneal Thickness with the Status of Diabetic Retinopathy and Level of HbA1C in Diabetic Patients

2021 ◽  
Vol 15 (12) ◽  
pp. 3387-3389
Author(s):  
Iftikhar , Ahmad ◽  
Fatima Akbar Shah ◽  
Muhammad Abid Javed ◽  
Muhammad Ahsen ◽  
Hafiz Huzaifa Akhlaq ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
The Status ◽  
The Mean ◽  
Relationship Of

Study Objectives: To determine the relationship of central corneal thickness with the status of diabetic retinopathy and level of HbA1c in diabetic patients. Study Design and Settings: Department of Ophthalmology, Allied Hospital/DHQ Hospital, Faisalabad Pakistan from Jan 2021 to June 2021. Patients and Methods: Out of the patients visiting OPD, 100 patients with clinically diagnosed type 2 DM which satisfied the range of selected standards and offered written informed agreement were involved in the research with the use of simple random sampling. Snellen’s visual acuity chart for distance vision and Jaeger’s chart for near vision were used to determine the best-corrected visual acuity. Wet Refraction and axial length was measured using A-scan. Goldmann applanation tonometry was used to measure the intraocular pressure. Results of the Study: In this research sixty two percent of the patients were men and thirty eight percent patients were women. Total 84 patients had type 2 DM of duration 5-10 years, and the remaining 16 patients had diabetes for over 10 years. Total 35 patients had HbA1c between 4-5.6%, 31 patients had HbA1c between 5.7- 6.5% and 34 patients had HbA1c ≥ 6.5%. From 100 patients with Diabetes Mellitus Type 2, 21 patients had no diabetic retinopathy, 28 patients had very minor and minor NPDR, 25 patients had average NPDR, 19 patients had critical and very acute NPDR and 7 patients had PDR. The mean HbA1c in patients with no diabetic retinopathy was 5.05%. The mean HbA1c in patients having minor and very little NPDR remained 5.64%. The mean HbA1c in patients with moderate NPDR was 6.36%. The mean HbA1c in patients with critical and very acute NPDR was 8.26%. The mean HbA1c in patients with severe PDR was 9.86%. This was a statistically significant survey (P-value = 0.01). Conclusion: This study showed a strong correlation between the central corneal thickness to the severity of diabetic retinopathy and HbA1c levels emphasizes the importance of evaluation of corneal endothelial morphology in the early screening and diagnosis of microvascular complications of DM Keywords: Central Corneal Thickness, Diabetic Retinopathy, HbA1c

scholarly journals Diabetic Retinopathy and Central Corneal Thickness

2019 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
The Mean

Background: Diabetes mellitus (DM) is a metabolic disease that can lead to many ocular complications such as increased Central Corneal Thickness (CCT), cataracts, and diabetic retinopathy. The aim of this study was to compare the CCT between subjects with type I and type II diabetes. Method: This was a retrospective study which included subjects with diabetes (with and without Diabetic Retinopathy (DR)) aged between 18 to 80 years old. The data collected were type and duration of diabetes mellitus, diabetes treatment, glycated hemoglobin level, visual acuity, CCT, and intra ocular pressure. Subjects were divided into subgroup (with and without DR). Statistical program (SPSS) was used to compare the central corneal thickness between the groups. Result: A total of 205 subjects with type I (n=100) and type II (n=105) diabetes were included in this study. In type 1 DM, the mean CCT was 547.06±27.3 microns in patients with diabetic retinopathy (DR) and 533.85±26.8 microns in patients without DR. In type 2 DM, the mean CCT was 542.85±39.3 microns in patients with DR and 532.44±27.4 microns in patients without DR. The CCT in type 1 diabetic patients was higher in both groups (with and without DR) than the CCT in type 2 diabetic patients in both groups (with and without DR). However, this was not statistically significant. Conclusion: The type of diabetes mellitus did not affect CCT. The presence of diabetic retinopathy in either type I or type II diabetes mellitus can affect the measurements of CCT.

scholarly journals Is the central corneal thickness of diabetic patients thicker than that of non-diabetics’ eyes?

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Solani D. Mathebula ◽  
Tshegofatso M. Segoati
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Central Corneal Thickness ◽  
Statistical Significance ◽  
Corneal Thickness ◽  
Control Group ◽  
Diabetic Patients ◽  
Study Group ◽  
Group 3 ◽  
The Mean

The purpose of the study was to evaluate central corneal thickness in diabetic patients and to compare the results with controls without diabetes mellitus. Sixty-five diabetic patients (65 eyes) constituted the study group, and 50 eyes were from the healthy control group (50 non-diabetic patients). The study group was subdivided into group 1 (no diabetic retinopathy, n = 35), group 2 (mild to moderate nonproliferative diabetic retinopathy, n = 20), and group 3 (proliferative diabetic retinopathy, n = 10). Central corneal thickness measurements in microns were determined using ultrasound pachymetry. The mean central corneal thickness was significantly greater in the study group (567.14 μm ± 14.63 μm) than in the control group (531.14 μm ± 5 μm). In addition, the mean central corneal thickness was found to be greater in group 3 (577 μm ± 12 μm) than in groups 1 (562 μm ± 13 μm) and 2 (566.86 μm ± 15 μm), but the difference did not reach statistical significance. We found that the mean central corneal thickness for diabetic patients was thicker than that of the healthy controls. Thicker central corneas associated with diabetes mellitus should be taken into consideration when obtaining accurate intraocular pressure measurements in diabetics.

Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes

2021 ◽  
pp. 112067212110637
Author(s):  
Victor A Augustin ◽  
Hyeck-Soo Son ◽  
Isabella Baur ◽  
Ling Zhao ◽  
Gerd U Auffarth ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Case Series ◽  
Biomechanical Analysis ◽  
Corvis St ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Best Corrected Visual Acuity ◽  
Fellow Eyes

Purpose To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus. Methods In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used. Results The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values. Conclusions Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.

Visual Outcomes, Quality of Life and Satisfaction After Phacoemulsification in Patients With Type 2 Diabetes Mellitus and Patients Without Diabetes

2020 ◽  
Author(s):  
Joao Beato ◽  
Sonia Torres-Costa ◽  
Joao Esteves-Leandro ◽  
Manuel Falcão ◽  
Vitor Rosas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Patient Reported Outcomes ◽  
Diabetic Patients ◽  
Patient Reported ◽  
Visual Function Questionnaire ◽  
The Mean ◽  
Type 2 Diabetic

Abstract BackgroundDiabetic retinopathy (DR) and cataract are major complications that lead to significant visual impairment of diabetic patients. This study aims to compare the changes in visual acuity, quality of life and satisfaction after phacoemulsification between type 2 diabetic and nondiabetic patients.MethodsFifty-seven diabetic patients (37 with no diabetic retinopathy [DR], 11 with mild/moderate nonproliferative DR and 9 with severe nonproliferative/proliferative DR) and 45 controls were submitted to first-eye cataract surgery by phacoemulsification alone or with co-adjuvant intravitreal injection of bevacizumab or triamcinolone. National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was recorded preoperatively and 6 months after surgery; and satisfaction evaluated at 1-month. ResultsCorrected distance visual acuity (CDVA) of the operated eye at 1 and 6-months (p<0.001) was significantly higher than preoperative value in the controls and all diabetic subgroups. The final CDVA in the severe nonproliferative/proliferative DR subgroup was significantly lower compared to the controls and the remaining diabetic subgroups (p<0.05). The mean NEI VFQ-25 composite score significantly improved in both control (15.413.2 points) and diabetic (15.413.0 points) groups, without differences among the diabetic subgroups (p>0.05). Overall patient satisfaction was 93% in both control and diabetic groups. ConclusionThis study provides vision-related patient-reported outcomes that support the benefit from phacoemulsification in all stages of DR, as long as there is adequate monitoring and treatment of retinopathy.

scholarly journals Multifocal Electroretinogram Can Detect the Abnormal Retinal Change in Early Stage of type2 DM Patients without Apparent Diabetic Retinopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jiang Huang ◽  
Yi Li ◽  
Yao Chen ◽  
Yuhong You ◽  
Tongtong Niu ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Early Stage ◽  
Multifocal Electroretinogram ◽  
Implicit Time ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Type 2 Diabetic Patients ◽  
Type 2 Dm ◽  
Retinal Change

Purpose. To study retinal function defects in type 2 diabetic patients without clinically apparent retinopathy using a multifocal electroretinogram (mf-ERG). Methods. Seventy-six eyes of thirty-eight type 2 diabetes mellitus(DM) patients without clinically apparent retinopathy and sixty-four normal eyes of thirty-two healthy control (HC) participants were examined using mf-ERG. Results. Patients with type 2 DM without apparent diabetic retinopathy demonstrated an obvious implicit time delay of P1 in ring 1, ring 3, and ring 5 compared with healthy controls ( t = 5.184 , p ≤ 0.001 ; t = 8.077 , p ≤ 0.001 ; t = 2.000 , p = 0.047 , respectively). The implicit time (IT) in ring 4 of N1wave was significantly delayed in the DM group ( t = 2.327 , p = 0.021 ). Compared with the HC group, the implicit time of the P1 and N1 waves in the temporal retina zone was significantly prolonged ( t = 3.66 , p ≤ 0.001 ; t = 2.187 , p = 0.03 , respectively). And the amplitude of P1 in the temporal retina decreased in the DM group, which had a significantly statistical difference with the healthy controls ( t = − 6.963 , p ≤ 0.001 ). However, there were no differences in either the amplitude of the response or the implicit time of the nasal retina zone between DM and HC. The AUC of multiparameters of mf-ERG was higher in the diagnosis of DR patients. Conclusions. Patients with type 2 DM without clinically apparent retinopathy had a delayed implicit time of P1 wave in temporal regions of the postpole of the retina compared with HC subjects. It demonstrates that mf-ERG can detect the abnormal retinal change in the early stage of type2 DM patients without apparent diabetic retinopathy. Multiparameters of mf-ERG can improve the diagnostic efficacy of DR, and it may be a potential clinical biomarker for early diagnosis of DR.

scholarly journals Corneal thickness and endothelial cell density in diabetic and non- diabetic patients: a hospital based comparative study

2018 ◽  
Vol 5 (3) ◽  
pp. 694 ◽  
Author(s):  
Nagaraj G. ◽  
Anasuya Sangaraj Desai ◽  
Nagesh Jayaram
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Diabetic Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Specular Microscopy ◽  
The Mean

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.

scholarly journals Correlation of Ankle-Brachial Index with Diabetic Retinopathy in Patients of Type 2 Diabetes

2020 ◽  
Vol 35 (4) ◽  
Author(s):  
Abdullah Mazhar ◽  
Tayyaba gul Malik ◽  
Aalia Ali ◽  
Hina Nadeem
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Blood Sugar ◽  
Teaching Hospital ◽  
Ankle Brachial Index ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Sugar Levels ◽  
Relationship Of

Objectives: To find out a relationship of diabetic retinopathy with ankle-brachial (ABI) in patients of type 2 diabetes. Material and Methods It was a cross-sectional observational study carried out in Arif Memorial Teaching hospital and Rashid Latif Medical College from January 2019 to June 2019. 120 patients were selected by purposive convenient sampling from outpatient department of Arif Memorial Teaching hospital. After clinical history, complete ocular examination was performed. Random blood sugar levels were measured using Glucometer. Ankle-brachial index was calculated by dividing the systolic pressure at ankle by the systolic blood pressure at arm. Statistical analysis was done using SPSS 25. Independent sample t test and chi square tests were used to find out the significance of the results. Results: In this study of 120 diabetic patients, 80 (66.7%) were female and 40 (33.3%) were males. Mean Ankle Branchial Index (ABI) of Males was 0.96±0.11 and for females was 0.97±0.14. Among 120 participants of this study, 73 (60.83 %) patients had no signs of diabetic retinopathy, 35 (29.16 %) patients had NPDR and 12 (10%) patients had PDR. ABI was not associated with gender and duration of diabetes. However, there was negative and weak linear relationship between BSR and ABI (r= -0.221). This correlation was higher in diabetics of less than 5 year duration (r=-0.286) than in patients of more than 5 years duration of diabetes (r=-0.129).  Conclusion: Our study indicates that ABI is not significantly related with diabetic retinopathy. However, there is a positive relationship of ABI with high blood sugar levels.

scholarly journals The effects of type 2 diabetes mellitus on the corneal endothelium and central corneal thickness

2020 ◽  
Author(s):  
Tae Gi Kim ◽  
Yoo Jin Kim
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Corneal Endothelial Cell ◽  
Control Group ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Significant Difference

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.

scholarly journals Association of hypertension and diabetic retinopathy in type 2 DM patients.

2020 ◽  
Vol 27 (10) ◽  
pp. 2056-2061
Author(s):  
Ali Saqib ◽  
Muhammad Sarfraz ◽  
Touseef Anwar ◽  
Muhammad Absar Alam ◽  
Rizwan Rasul Khan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diabetic Retinopathy ◽  
Strong Association ◽  
Mean Value ◽  
University Hospital ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Dm ◽  
Group B

Objectives: To evaluate the association of hypertension and diabetic retinopathy in type 2 DM patients. Study Design: Case Control study. Setting: Diabetic Clinic Department of Medicine, Independent University Hospital, Faisalabad. Period: From January 2019 to June 2019. Material & Methods: One Hundred Type 2 diabetic patients of either sex were reviewed and these patients were screened for diabetic retinopathy using welchallyn ophthalmoscope. The patients with diabetic retinopathy fulfilling the inclusion criteria were placed in group A (cases) and patients without diabetic retinopathy were placed in group B (control). After resting the patient in supine position for 5 minutes, blood pressure (BP) measurements were taken in all these patients using mercury sphygmomanometer in two successive out-patient department visits, and mean value of B.P. was taken. All patients were asked for duration of diabetes, hypertension and visual problems specifically. These patients were advised following investigations: - FBS. - RBS. - HbAlc. Relevant statistics, mean & standard deviation were computed for variables. T-test was applied on hypertension (independent) and DM retinopathy (dependent) variables. Results: Systolic and diastolic blood pressure were significantly higher in the patients with retinopathy (mean systolic B.P 153.4± 17.13 and mean diastolic B.P. 84.1±9.26) than in those without retinopathy (mean systolic B.P. 130.65±11.94 and mean diastolic B.P 77.3 ±6.64). There was significant correlation of diabetic retinopathy with systolic hypertension (P<0.05) and diastolic hypertension (P<0.001). Conclusion: There is strong association between diabetic retinopathy and hypertension. So early detection and treatment of hypertension can retard the development and progression of diabetic retinopathy.

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