Comparison of Corneal Endothelial Cell Morphology in Type-2 Diabetes and Nondiabetics

Overview

Journal Oman J Ophthalmol

Specialty Ophthalmology

Date 2024 Dec 9

PMID 39651497

Authors

Maryam Firdous

Saif Ullah

Mutahir Shah

Sadaf Qayyum

Muhammad Hasan Ansari

Amtul Aziz

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to evaluate and compare the values of hexagonality of endothelial cells among type-2 diabetics and nondiabetics. It also aimed at finding the correlation of the hexagonality of endothelial cells with the duration of diabetes, random blood sugar level, and severity of diabetic retinopathy in type-2 diabetics.

Materials And Methods: A comparative cross-sectional study was conducted for 8 months from January to August 2022. The data was collected from tertiary care eye hospital named Al-Shifa Trust Eye hospital jhelum road, Rawalpindi, Pakistan. After taking the informed consent, a complete history of each subject was taken. Visual acuity and refraction were performed using Early Treatment Diabetic Retinopathy Study visual acuity chart and then, complete slit-lamp anterior and posterior segment examination was performed followed by specular microscopy (TOMEY Specular Microscope EM-4000) to evaluate endothelial cell hexagonality. The diabetic subjects were checked for their random blood sugar levels immediately after specular microscopy using a digital glucometer and the readings were recorded.

Results: Results showed that the hexagonality of endothelial cells was statistically significantly lower ( = 0.000) in type-2 diabetics than in nondiabetics. Correlation analysis of the hexagonality of endothelial cells showed a negative correlation ( < 0.05) with random blood sugar levels while no correlation ( > 0.05) with the duration of diabetes and severity of diabetic retinopathy.

Conclusion: The study concluded that the hexagonality of endothelial cells was significantly different among the two groups under study, i.e., type-2 diabetics and nondiabetics.

References

Papadakou P, Chatziralli I, Papathanassiou M, Lambadiari V, Siganos C, Theodossiadis P . The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study. Ophthalmic Res. 2020; 63(6):550-554. DOI: 10.1159/000507197. View

Sudhir R, Raman R, Sharma T . Changes in the corneal endothelial cell density and morphology in patients with type 2 diabetes mellitus: a population-based study, Sankara Nethralaya Diabetic Retinopathy and Molecular Genetics Study (SN-DREAMS, Report 23). Cornea. 2012; 31(10):1119-22. DOI: 10.1097/ICO.0b013e31823f8e00. View

Zhang J, Chen Y, Zou L, Gong R . Prognostic nutritional index as a risk factor for diabetic kidney disease and mortality in patients with type 2 diabetes mellitus. Acta Diabetol. 2022; 60(2):235-245. PMC: 9629877. DOI: 10.1007/s00592-022-01985-x. View

El-Agamy A, Alsubaie S . Corneal endothelium and central corneal thickness changes in type 2 diabetes mellitus. Clin Ophthalmol. 2017; 11:481-486. PMC: 5338984. DOI: 10.2147/OPTH.S126217. View

Ul Islam Q, Mehboob M, Amin Z . Comparison of corneal morphological characteristics between diabetic and non diabetic population. Pak J Med Sci. 2018; 33(6):1307-1311. PMC: 5768815. DOI: 10.12669/pjms.336.13628. View

Storr-Paulsen A, Singh A, Jeppesen H, Norregaard J, Thulesen J . Corneal endothelial morphology and central thickness in patients with type II diabetes mellitus. Acta Ophthalmol. 2013; 92(2):158-60. DOI: 10.1111/aos.12064. View

Durukan I . Corneal endothelial changes in type 2 diabetes mellitus relative to diabetic retinopathy. Clin Exp Optom. 2019; 103(4):474-478. DOI: 10.1111/cxo.12971. View

Mansour S, Browning D, Wong K, Flynn Jr H, Bhavsar A . The Evolving Treatment of Diabetic Retinopathy. Clin Ophthalmol. 2020; 14:653-678. PMC: 7061411. DOI: 10.2147/OPTH.S236637. View

Siribunkum J, Kosrirukvongs P, Singalavanija A . Corneal abnormalities in diabetes. J Med Assoc Thai. 2002; 84(8):1075-83. View

10.

Choo M, Prakash K, Samsudin A, Soong T, Ramli N, Kadir A . Corneal changes in type II diabetes mellitus in Malaysia. Int J Ophthalmol. 2012; 3(3):234-6. PMC: 3340640. DOI: 10.3980/j.issn.2222-3959.2010.03.12. View

11.

Beato J, Esteves-Leandro J, Reis D, Falcao M, Rosas V, Carneiro A . Corneal structure and endothelial morphological changes after uneventful phacoemulsification in type 2 diabetic and nondiabetic patients. Arq Bras Oftalmol. 2021; 84(5):454-461. PMC: 11878423. DOI: 10.5935/0004-2749.20210071. View

12.

Browning D, Stewart M, Lee C . Diabetic macular edema: Evidence-based management. Indian J Ophthalmol. 2018; 66(12):1736-1750. PMC: 6256891. DOI: 10.4103/ijo.IJO_1240_18. View

13.

Hanff T, Cohen J, Zhao L, Javaheri A, Zamani P, Prenner S . Quantitative Proteomic Analysis of Diabetes Mellitus in Heart Failure With Preserved Ejection Fraction. JACC Basic Transl Sci. 2021; 6(2):89-99. PMC: 7907637. DOI: 10.1016/j.jacbts.2020.11.011. View

14.

Gupta P, Berdahl J, Chan C, Rocha K, Yeu E, Ayres B . The corneal endothelium: clinical review of endothelial cell health and function. J Cataract Refract Surg. 2021; 47(9):1218-1226. DOI: 10.1097/j.jcrs.0000000000000650. View

15.

Ono T, Mori Y, Nejima R, Iwasaki T, Miyai T, Miyata K . Corneal endothelial cell density and morphology in ophthalmologically healthy young individuals in Japan: An observational study of 16842 eyes. Sci Rep. 2021; 11(1):18224. PMC: 8440503. DOI: 10.1038/s41598-021-97776-5. View

16.

Beato J, Esteves-Leandro J, Reis D, Falcao M, Rosas V, Carneiro A . Structural and Biomechanical Corneal Differences between Type 2 Diabetic and Nondiabetic Patients. J Ophthalmol. 2019; 2019:3764878. PMC: 6442329. DOI: 10.1155/2019/3764878. View

17.

Antal B, McMahon L, Sultan S, Lithen A, Wexler D, Dickerson B . Type 2 diabetes mellitus accelerates brain aging and cognitive decline: Complementary findings from UK Biobank and meta-analyses. Elife. 2022; 11. PMC: 9132576. DOI: 10.7554/eLife.73138. View

18.

Izzo A, Massimino E, Riccardi G, Della Pepa G . A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors. Nutrients. 2021; 13(1). PMC: 7826709. DOI: 10.3390/nu13010183. View

19.

Tananuvat N, Khumchoo N . Corneal thickness and endothelial morphology in Normal Thai eyes. BMC Ophthalmol. 2020; 20(1):167. PMC: 7187506. DOI: 10.1186/s12886-020-01385-1. View

20.

Khalid M, Hanif M, Ul Islam Q, Mehboob M . Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus. Pak J Med Sci. 2019; 35(5):1366-1369. PMC: 6717492. DOI: 10.12669/pjms.35.5.596. View