Evaluation of type 2 diabetes mellitus effect on human cornea using specular microscopy and Pentacam corneal tomography

Abstract

Purpose evaluating effect of type 2 DM using pentacam and specular microscopy, and correlate changes to DM and its control. Methods A randomized cross sectional study . Ninty eyes of 45 patients were examined by pentacam HR; where elevation based anterior corneal elevation (ACE) and and thickness based and ARTmax indices were recorded and Specular Microscopy were and indices were evaluated . Corneas were categorized into 3 groups according to HBA1C level; group 1 (30eyes) with uncontrolled DM,group 2 (30eyes) with controlled DM,while group 3 (30 eyes) with healthy controls. Possible effect of DM on the forementioned indices was evaluated and a correlation between HBA1C and these indices was investigated. Results regarding Pentacam elevation indices (ACE, PCE), PCE showed a significant increase in group 1 compared to group 3 (p-value=0.005), while ACE showed a significant increase between group 2 and each of group 1 (p-value =0.031) and group 3 (p-value=0.025). AS regard to pachymetric indices, TCT and ART max showed a significant difference between group 1 and group 3 (p=0.001 and 0.048). Specular Microscopy indices; ECD showed a significant difference between each of (group 1, group 2) diabetics and group 3 (p=0.001), while CV showed a significant increase in group 1 compared to group 3 (p=0.005). Regression analyses showed positive correlations between HBA1C and each of PCE, TCT, ART max, ECD, CV. Conclusion Some pentacam indices showed significant changes with variations in HBA1C level ,which are sensitive indices in ectasia detection. Regular follow up of type 2 diabetics by performing pentacam is recommended, especially for uncontrolled DM.