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Subject Area

Public Health

Article Type

Original Study

Abstract

Objective The aim of this study was to evaluate the changes in corneal endothelium (endothelial cell morphology and density) and central corneal thickness (CCT) in type II diabetes mellitus. Background Worldwide, the incidence of type II diabetes mellitus is increasing, reaching epidemic proportions in developing countries. Diabetes mellitus can affect almost all structures of the eye; it can cause anterior ischemic optic neuropathy, glaucoma, cataract, retinal vascular occlusions, and retinopathy. Corneal damage such as endothelial defects, punctate epithelial keratopathy, recurrent corneal erosions, and persistent epithelial defects may occur. The disease affects the corneal endothelial cells and corneal thickness. Patients and methods This analytical and descriptive study included 200 eyes of 100 diabetic patients and 100 healthy controls, 98 left and 102 right eyes; there were 125 were female and 80 male patients. Patients' ages ranged between 41 and 65 years. The following parameters were evaluated in the current study in both the healthy control group and age-matched patients with type II diabetes mellitus: central corneal thickness, endothelial cell count, coefficient of variation, and percentage of hexagonal cells. Results Endothelial cell density in the diabetic group (2262.1 ± 344.5 cells/mm2) was significantly lower than that in the control group (2623.07 ± 187.1 cells/mm2, <0.05). The coefficient of variation of cell area was significantly higher in diabetic patients. Hexagonality was significantly lower in diabetic patients, and CCT was significantly higher in diabetic patients. The diabetic group was subdivided according to severity of diabetic retinopathy (DR) into no DR, nonproliferative DR and proliferative DR. Duration of diabetes and severity of DR were significantly correlated with corneal endothelial changes. Conclusion Type II diabetes causes a significant alteration in corneal structure and function in the long term. Our study seems to confirm the effect of diabetes duration and poor glycemic control on CCT and endothelial cell structure and morphology.

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