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Abstract
SIGNIFICANCE This study suggests that despite having comparable best-corrected visual acuity and normal fundus appearance, objective measurements of optical quality showed that patients with diabetes but without overt retinopathy may have impaired visual function. Screening using the Optical Quality Analysis System might help identify those patients. PURPOSE Visual impairments are common in diabetes, but the status of the problem is unclear before the development of diabetic retinopathy. The aim of this pilot study was to investigate the optical quality and intraocular scattering in the diabetic eye without diabetic retinopathy. METHODS Twenty-seven patients with diabetes without diabetic retinopathy were enrolled. Twenty-seven age- and sex-matched healthy volunteers served as a control group. Optical quality parameters included modulation transfer function cutoff frequency, Strehl (two-dimensional) ratio, and Optical Quality Analysis System values at 100, 20, and 9 contrast levels. The objective scatter index was assessed using the Optical Quality Analysis System. Correlations were analyzed between the modulation transfer function cutoff, Strehl ratio, objective scatter index, and Optical Quality Analysis System value, and the age of the patient and the duration of diabetes mellitus. RESULTS The diabetic group exhibited lower modulation transfer function cutoff, Strehl ratio, and Optical Quality Analysis System values at 100, 20, and 9% contrast levels and higher objective scatter index than did the controls (all, P < .01). There were no associations between the optical quality parameters and age or the duration of diabetes mellitus in the diabetic participants (all, P > .05). Moderate associations were found between all parameters obtained from the Optical Quality Analysis System and age in the control group (all, P < .01). CONCLUSIONS This pilot study suggests that optical quality was reduced, and intraocular scattering increased in the diabetic eye without diabetic retinopathy compared with controls.
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Zhao H, He Y, Ren YR, Chen BH. Corneal alteration and pathogenesis in diabetes mellitus. Int J Ophthalmol 2019; 12:1939-1950. [PMID: 31850180 DOI: 10.18240/ijo.2019.12.17] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/12/2019] [Indexed: 12/15/2022] Open
Abstract
The incidence of diabetes mellitus (DM) and its complications have increased considerably worldwide. Diabetic keratopathy is the major complication of the cornea characterized by delayed corneal wound healing, decreasing corneal epithelial sensitivity, and recurrent corneal ulcers. There is accumulating evidence that diabetic keratopathy is correlated with the hyperglycemic state. Different corneal components may produce different alterations under hyperglycemia. In addition, diabetic nerve alteration may become a novel biomarker of early-stage DM. Abnormalities of the corneal nerve plexus have been associated with diabetic inflammatory states. There is rapidly growing evidence based on investigations of diabetic corneal nerves through in vivo confocal microscopy. Understanding the molecular pathogenesis caused by hyperglycemia may assist in the identification of novel biomarkers, as well as therapeutic targets for early treatment. This review mainly summarizes recent findings on corneal alteration and pathogenesis in DM.
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Affiliation(s)
- Han Zhao
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Yan He
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Yue-Rong Ren
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
| | - Bai-Hua Chen
- Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha 410011, Hunan Province, China
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An Update on Corneal Biomechanics and Architecture in Diabetes. J Ophthalmol 2019; 2019:7645352. [PMID: 31275634 PMCID: PMC6589322 DOI: 10.1155/2019/7645352] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/02/2019] [Indexed: 12/12/2022] Open
Abstract
In the last decade, we have witnessed substantial progress in our understanding of corneal biomechanics and architecture. It is well known that diabetes is a systemic metabolic disease that causes chronic progressive damage in the main organs of the human body, including the eyeball. Although the main and most widely recognized ocular effect of diabetes is on the retina, the structure of the cornea (the outermost and transparent tissue of the eye) can also be affected by the poor glycemic control characterizing diabetes. The different corneal structures (epithelium, stroma, and endothelium) are affected by specific complications of diabetes. The development of new noninvasive diagnostic technologies has provided a better understanding of corneal tissue modifications. The objective of this review is to describe the advances in the knowledge of the corneal alterations that diabetes can induce.
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Adnan, Atchison DA. Changes in straylight and corneal light scattering in a newly diagnosed case of type 2 diabetes. Clin Exp Optom 2016; 98:481-2. [PMID: 26390911 DOI: 10.1111/cxo.12270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 11/16/2014] [Accepted: 11/27/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Adnan
- Institute of Health & Biomedical Innovation and School of Optometry & Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David A Atchison
- Institute of Health & Biomedical Innovation and School of Optometry & Vision Science, Queensland University of Technology, Brisbane, Australia
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Misra SL, Braatvedt GD, Patel DV. Impact of diabetes mellitus on the ocular surface: a review. Clin Exp Ophthalmol 2016; 44:278-88. [PMID: 26661628 DOI: 10.1111/ceo.12690] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/05/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Stuti L Misra
- Department of Ophthalmology, New Zealand National Eye Centre Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Geoffrey D Braatvedt
- Department of Medicine, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Dipika V Patel
- Department of Ophthalmology, New Zealand National Eye Centre Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
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Hwang HB, Yim HB, Chung SK. Effect of diabetic retinopathy and diabetes on the intraocular straylight in pseudophakic eyes. BMC Ophthalmol 2015; 15:130. [PMID: 26464020 PMCID: PMC4604714 DOI: 10.1186/s12886-015-0120-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 09/29/2015] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to prove the relationship between the intraocular straylight level and diabetic retinopathy (DR) according to disease severity. Also, we aimed to evaluate whether diabetes mellitus (DM) per se could be a risk factor of increased intraocular straylight although we did not rely on a definite sign of DR in this study. Methods In this prospective comparative study, ninety three eyes were enrolled and divided into four groups as follows: Group 1 (26 eyes), without DR or DM; Group 2 (25 eyes), with DM but without DR; Group 3 (21 eyes), mild to moderate non-proliferative DR; and Group 4 (21 eyes), severe non-proliferative DR. To measure the intraocular straylight in an objective manner, the C-quant straylight meter was used to preoperatively and 2 months postoperatively in all patients who underwent phacoemulsification surgery. All the patients also underwent a macular optical coherence tomography and hemoglobin A1c (HbA1c) analysis. A comparison of straylight levels adjusted by age among four groups was performed postoperatively. Results The postoperative level of intraocular straylight was statistically significantly different among four groups (P <0.05). When adjusted for ages, Group 4 showed the highest straylight level when compared with Group 3 and the other two groups (P <0.05). Group 1 showed the lowest straylight level in comparison with Group 2 and the other two groups (P <0.05). There was no significant correlation between HbA1c level, duration of diabetes and postoperative straylight level. Conclusions The level of intraocular straylight at 2 months postoperatively had a tendency to increase as the severity of DR increased. Additionally, the straylight level was higher in DM patients without DR than in patients without DM. Therefore, the severity of DR seemed to influence the intraocular straylight level. Although there is no definite sign of DR, DM per se can be a risk factor for increasing intraocular straylight. In conclusion, the level of intraocular straylight seems to be a sensitive test for detecting early retinal damage secondary to DM.
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Affiliation(s)
- Hyung Bin Hwang
- Department of Ophthalmology and Visual Science, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Hye Bin Yim
- Department of Ophthalmology and Visual Science, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Sung Kun Chung
- Postal address: Department of Ophthalmology and Visual Science, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
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Adnan X, Suheimat M, Mathur A, Efron N, Atchison DA. Straylight, lens yellowing and aberrations of eyes in Type 1 diabetes. BIOMEDICAL OPTICS EXPRESS 2015; 6:1282-1292. [PMID: 25909012 PMCID: PMC4399667 DOI: 10.1364/boe.6.001282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/01/2015] [Accepted: 03/03/2015] [Indexed: 06/04/2023]
Abstract
Straylight, lens yellowing and ocular aberrations were assessed in a group of people with type 1 diabetes and in an age matched control group. Most of the former had low levels of neuropathy. Relative to the control group, the type 1 diabetes group demonstrated greater straylight, greater lens yellowing, and differences in some higher-order aberration co-efficients without significant increase in root-mean-square higher-order aberrations. Differences between groups did not increase significantly with age. The results are similar to the findings for ocular biometry reported previously for this group of participants, and suggest that age-related changes in the optics of the eyes of people with well-controlled diabetes need not be accelerated.
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Calvo-Maroto AM, Perez-Cambrodí RJ, Albarán-Diego C, Pons A, Cerviño A. Optical quality of the diabetic eye: a review. Eye (Lond) 2014; 28:1271-80. [PMID: 25125072 DOI: 10.1038/eye.2014.176] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/26/2014] [Indexed: 12/15/2022] Open
Abstract
Diabetes mellitus is a metabolic disorder characterized by the presence of chronic hyperglycaemia. Several structural, morphological, and physiological changes in each of ocular component have been described in detail during the past decades. Due to these abnormalities, the diabetic patient undergoes a degradation of the retinal image by an increase of higher ocular aberrations and ocular scattering coming from mainly tear film, cornea, and crystalline lens. This review aims to provide an overview of current knowledge about the effects of diabetes mellitus in these optical phenomena and its consequence on the visual quality of the diabetic patient.
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Affiliation(s)
- A M Calvo-Maroto
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
| | - R J Perez-Cambrodí
- Department of Ophthalmology, Oftalmar, Medimar International Hospital, Alicante, Spain
| | - C Albarán-Diego
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
| | - A Pons
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
| | - A Cerviño
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
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Kowalczuk L, Latour G, Bourges JL, Savoldelli M, Jeanny JC, Plamann K, Schanne-Klein MC, Behar-Cohen F. Multimodal Highlighting of Structural Abnormalities in Diabetic Rat and Human Corneas. Transl Vis Sci Technol 2013; 2:3. [PMID: 24049714 PMCID: PMC3763890 DOI: 10.1167/tvst.2.2.3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 01/20/2013] [Indexed: 01/17/2023] Open
Abstract
PURPOSE This study aimed to highlight structural corneal changes in a model of type 2 diabetes, using in vivo corneal confocal microscopy (CCM). The abnormalities were also characterized by transmission electron microscopy (TEM) and second harmonic generation (SHG) microscopy in rat and human corneas. METHODS Goto-Kakizaki (GK) rats were observed at age 12 weeks (n = 3) and 1 year (n = 6), and compared to age-matched controls. After in vivo CCM examination, TEM and SHG microscopy were used to characterize the ultrastructure and the three-dimensional organization of the abnormalities. Human corneas from diabetic (n = 3) and nondiabetic (n = 3) patients were also included in the study. RESULTS In the basal epithelium of GK rats, CCM revealed focal hyper-reflective areas, and histology showed proliferative cells with irregular basement membrane. In the anterior stroma, extracellular matrix modifications were detected by CCM and confirmed in histology. In the Descemet's membrane periphery of all the diabetic corneas, hyper-reflective deposits were highlighted using CCM and characterized as long-spacing collagen fibrils by TEM. SHG microscopy revealed these deposits with high contrast, allowing specific detection in diabetic human and rat corneas without preparation and characterization of their three-dimensional organization. CONCLUSION Pathologic findings were observed early in the development of diabetes in GK rats. Similar abnormalities have been found in corneas from diabetic patients. TRANSLATIONAL RELEVANCE This multidisciplinary study highlights diabetes-induced corneal abnormalities in an animal model, but also in diabetic donors. This could constitute a potential early marker for diagnosis of hyperglycemia-induced tissue changes.
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Affiliation(s)
- Laura Kowalczuk
- Laboratory of Applied Optics, ENSTA ParisTech - École Polytechnique – CNRS, chemin de la Hunière, Palaiseau cedex, France
- INSERM UMRS 872, Team17, Physiopathology of ocular diseases, therapeutic innovations, 15 rue de l'école de médecine, Paris, France
- Pierre et Marie Curie University, Centre de Recherches des Cordeliers, 15 rue de l'école de médecine, Paris, France
- Sorbonne Paris Cité, Paris Descartes University, AP-HP Hôtel-Dieu Hospital, Department of Ophthalmology, 1 place du Parvis Notre-Dame, Paris, France
| | - Gaël Latour
- Laboratory for Optics and Biosciences, École Polytechnique – CNRS – INSERM U696, Palaiseau, France
| | - Jean-Louis Bourges
- INSERM UMRS 872, Team17, Physiopathology of ocular diseases, therapeutic innovations, 15 rue de l'école de médecine, Paris, France
- Pierre et Marie Curie University, Centre de Recherches des Cordeliers, 15 rue de l'école de médecine, Paris, France
- Sorbonne Paris Cité, Paris Descartes University, AP-HP Hôtel-Dieu Hospital, Department of Ophthalmology, 1 place du Parvis Notre-Dame, Paris, France
| | - Michèle Savoldelli
- Sorbonne Paris Cité, Paris Descartes University, AP-HP Hôtel-Dieu Hospital, Department of Ophthalmology, 1 place du Parvis Notre-Dame, Paris, France
| | - Jean-Claude Jeanny
- INSERM UMRS 872, Team17, Physiopathology of ocular diseases, therapeutic innovations, 15 rue de l'école de médecine, Paris, France
- Pierre et Marie Curie University, Centre de Recherches des Cordeliers, 15 rue de l'école de médecine, Paris, France
- Sorbonne Paris Cité, Paris Descartes University, AP-HP Hôtel-Dieu Hospital, Department of Ophthalmology, 1 place du Parvis Notre-Dame, Paris, France
| | - Karsten Plamann
- Laboratory of Applied Optics, ENSTA ParisTech - École Polytechnique – CNRS, chemin de la Hunière, Palaiseau cedex, France
| | | | - Francine Behar-Cohen
- INSERM UMRS 872, Team17, Physiopathology of ocular diseases, therapeutic innovations, 15 rue de l'école de médecine, Paris, France
- Pierre et Marie Curie University, Centre de Recherches des Cordeliers, 15 rue de l'école de médecine, Paris, France
- Sorbonne Paris Cité, Paris Descartes University, AP-HP Hôtel-Dieu Hospital, Department of Ophthalmology, 1 place du Parvis Notre-Dame, Paris, France
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Efficacy of substance P and insulin-like growth factor-1 peptides for preventing postsurgical superficial punctate keratopathy in diabetic patients. Jpn J Ophthalmol 2009; 53:464-9. [DOI: 10.1007/s10384-009-0693-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Accepted: 02/16/2009] [Indexed: 11/26/2022]
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