Cross-sectional Study on Measurement of Central Corneal Thickness in Type 2 Diabetes Mellitus Using Pachymeter

Abstract

INTRODUCTION: Diabetic mellitus causes decrease in corneal endothelial cell density and hexagonality, whereas increases polymegathism, pleomorphism and central corneal thickness. Corneal pachymetry measures corneal thickness, a sensitive indicator of endothelial physiology that correlates well with functional measurements. The increase in Central Cornea Thickness seems to be present very early in the disease and thus may be one of the earliest clinically detectable changes of diabetic eye. The association between increased corneal thickness and severe retinal complications suggests that the corneal thickness may be an indicator of the risk of retinal complications.

METHOD: This was cross-sectional, hospital based cross sectional study in 59 diabetic patient that was done in Nepal Eye hospital general ophthalmology OPD and in Retina Clinic in a time period of 18 months. Patients underwent comprehensive ophthalmic examination including dilated fundus examination with a 90-D lens, Intraocular pressure (IOP) measurement with a Goldmann applanation tonometer and central corneal thickness measured using ultrasound pachymetry (ACCUTOME).

RESULT: The findings revealed statistically significant increase in central corneal thickness with increase duration of diabetes(p=0.043), random blood sugar more than 200 mg/dl (p=0.04), HbA1c more than 6.5(p=0.025). However, there was no statistically significant change in central corneal thickness in relation to subgroup of diabetic retinopathy patient, age of patient and gender.

CONCLUSION: This study shows that persons with diabetes mellitus or higher glycosylated hemoglobin levels have greater CCT, independent of age, gender. These findings suggest that CCT measurements may be affected by chronic hyperglycemia and, together with future research findings, may aid in understanding the pathophysiological processes in diabetes.