Abstract
ObjectivesTo compare the anterior ocular segment biometry among Type 2 diabetes mellitus (DM) with no diabetic retinopathy (DR) and non-proliferative diabetic retinopathy (NPDR), and to evaluate the correlation of anterior ocular segment biometry with HbA1c level.MethodsA cross-sectional study was conducted in Hospital Universiti Sains Malaysia, Kelantan from November 2013 till May 2016 among Type 2 DM patients (DM with no DR and DM with NPDR). The patients were evaluated for anterior ocular segment biometry [central corneal thickness (CCT), anterior chamber width (ACW), angle opening distance (AOD) and anterior chamber angle (ACA)] by using Anterior Segment Optical Coherence Tomography (AS-OCT). Three ml venous blood was taken for the measurement of HbA1c.ResultsA total of 150 patients were included in this study (DM with no DR: 50 patients, DM with NPDR: 50 patients, non DM: 50 patients as a control group). The mean CCT and ACW showed significant difference among the three groups (p < 0.001 and p = 0.015 respectively). Based on post hoc result, there were significant mean difference of CCT between non DM and DM with NPDR (mean difference 36.14 μm, p < 0.001) and also between non DM and DM with no DR (mean difference 31.48 μm, p = 0.003). The ACW was significantly narrower in DM with NPDR (11.39 mm SD 0.62) compared to DM with no DR (11.76 mm SD 0.53) (p = 0.012). There were no significant correlation between HbA1c and all the anterior ocular segment biometry.ConclusionDiabetic patients have significantly thicker CCT regardless of retinopathy status whereas ACW was significantly narrower in DM with NPDR group compared to DM with no DR. There was no significant correlations between HbA1c and all anterior ocular segment biometry in diabetic patients regardless of DR status.
Highlights
Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia [fasting plasma glucose !126 mg/dl (7.0 mmol/l) or 2-h plasma glucose !200 mg/dl (11.1 mmol/ l)] resulting from defects in insulin secretion, insulin action, or both [1]
A total of 150 patients were included in this study (DM with no Diabetic retinopathy (DR): 50 patients, DM with non-proliferative diabetic retinopathy (NPDR): 50 patients, non DM: 50 patients as a control group)
The anterior chamber width (ACW) was significantly narrower in DM with NPDR (11.39 mm standard deviation (SD) 0.62) compared to DM with no DR (11.76 mm SD 0.53) (p = 0.012)
Summary
Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia [fasting plasma glucose !126 mg/dl (7.0 mmol/l) or 2-h plasma glucose !200 mg/dl (11.1 mmol/ l)] resulting from defects in insulin secretion, insulin action, or both [1]. Type 1 diabetes mellitus results from the body’s failure to produce insulin, and requires the person to inject insulin or wear an insulin pump. Type 2 diabetes mellitus results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. There are many risk factors for DR. Significant systemic risk factors include hypertension and high glycosylated haemoglobin A1c (HbA1c), systolic blood pressure, pulse pressure, serum lipoprotein level and body mass index. Periodic eye examinations together with good glycemic control are the initial steps to reduce the risk of ocular complications. Other measure include stabilisation of systemic risk factors such as hypertension, hyperlipidaemia, and anaemia [2, 3]
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