A Cross-Sectional Study Comparing Corneal Parameters Using Specular Microscopy in Type Ii Diabetes Mellitus Patients with and Without Retinopathy in a Tertiary Care Centre at Chengalpattu District

Abstract

Introduction: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycaemia leading to microvascular complications such as diabetic retinopathy, a major cause of preventable blindness  in India. Diabetes can alter corneal endothelial parameters, including reduced endothelial cell density and hexagonality, increased central corneal thickness, and increased coefficient of variation. Specular microscopy is a non-invasive tool used to evaluate these endothelial parameters. Assessment of corneal endothelial parameters in type II diabetes mellitus patients is important, as they are at increased risk of endothelial dysfunction and postoperative corneal decompensation, and these parameters may serve as useful biomarkers for early detection and monitoring

Objectives: To evaluate and compare  the corneal endothelial parameters-endothelial cell                  density, the proportion of hexagonal cells, coefficient of variation and the central corneal thickness  among patients with type II diabetes mellitus with and without retinopathy.

Methods : : This study was conducted among 92  Type II diabetes  patients in which half of them were having diabetic retinopathy. After routine ocular examination, corneal endothelial parameters—Endothelial Cell Density (ECD), hexagonality, Central Corneal Thickness (CCT), and Coefficient of Variation (CV - Variation in size of corneal endothelial cells) were assessed using the NIDEK CEM-530 Specular Microscope. Data were analyzed using SPSS software, and group comparisons were performed with a significance level of p < 0.05.

Results: Patients with diabetic retinopathy showed statistically significantly higher      central corneal thickness and coefficient of variation compared to those without retinopathy (p < 0.05). In contrast, endothelial cell density and hexagonality were  showed significantly lower in the retinopathy group. These findings highlights  marked corneal endothelial alterations associated with diabetic retinopathy.

Conclusion: : Diabetic patients with  retinopathy showed significant changes in corneal endothelial parameters, suggesting the importance of routine corneal evaluation in diabetic patients for early detection and better management.