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Sanchis-Gimeno JA, Hasrod N, Calvo-Maroto AM, Nalla S, Cerviño A. Effect of diabetes mellitus on quantitative corneal anatomy – A systemic review. AFRICAN VISION AND EYE HEALTH 2022. [DOI: 10.4102/aveh.v81i1.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Corneal changes occur as a direct consequence of diabetes mellitus (DM). The central corneal thickness (CCT) is a useful parameter that provides information about the status of the metabolism of the cornea and can therefore help monitor the progression of DM.Aim: The aim of this study was to determine the impact of DM on CCT and its correlation with diabetes duration and glycated haemoglobin (HbA1c) levels.Methods: The systematic review was undertaken to answer: (1) What effect does DM have on CCT values? (2) What effect does DM duration have on CCT values? (3) What effect does HbA1c levels have on CCT values? The Web of Science was used to conduct a computerised search for articles of CCT values in DM.Results: A total of 38 articles that met the criteria for inclusion were included in this systemic review. The researchers found 27 articles that observed increased CCT values in DM patients compared with control subjects. There were six studies in which increased CCT values were related to DM duration and 12 studies in which DM duration did not alter CCT values. Also, eight studies showed that CCT values increased with glycated haemoglobin levels, and 12 studies did not observe this.Conclusion: Diabetes mellitus patients usually present with increased CCT values although there is no unanimity about the effect of DM duration and increased HbA1c levels (poor glycaemic control) in the CCT values of DM patients.
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Kuo YK, Shao SC, Lin ET, Pan LY, Yeung L, Sun CC. Tear function in patients with diabetes mellitus: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:1036002. [PMID: 36339435 PMCID: PMC9633841 DOI: 10.3389/fendo.2022.1036002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To examine tear function in patients with diabetes mellitus (DM). DESIGN Systematic review and meta-analysis. METHOD We searched Embase and PubMed from database inception to March 16, 2022. We included observational studies that compared tear function between patients with and without DM. Tear function was measured using invasive tear breakup time (ITBUT) and Schirmer's 1 test. Pooled results are presented as standard mean difference (SMD) with 95% confidence interval (CI) based on random-effects models. RESULTS We included 59 studies (7,234 eyes) comparing the tear function between patients with and without DM. This meta-analysis indicated that patients with DM had worse tear function than those without DM (ITBUT: SMD: -0.98, 95% CI: -1.27 to -0.69; Schirmer's 1 test: SMD: -0.45, 95% CI: -0.64 to -0.26), and the results remained consistent in patients with different types of DM (e.g., type 1 DM and type 2 DM) and from different ethnic backgrounds (e.g., Asian vs. non-Asian). Patients with DM under poor glycemic control had worse tear function than those of the non-DM group (ITBUT: SMD: -1.26, 95% CI: -1.86 to -0.66; Schirmer's 1 test: SMD: -0.25, 95% CI: -0.48 to -0.02), whereas there were no significant differences in tear function between patients with DM under optimal glycemic control and non-DM groups. CONCLUSIONS We found that patients with type 1 or type 2 DM had significantly reduced tear function. The level of tear function could be determined by glycemic control, and therefore, our findings suggest that glycemic control in patients with DM is critical for maintaining tear function. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero, identifier CRD42021250498.
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Affiliation(s)
- Yu-Kai Kuo
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Shao
- Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Erh-Tsan Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Yen Pan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ling Yeung
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Chi-Chin Sun,
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Akyol‐salman İ, Azizi S, Mumcu U, Öndaş O, Baykal O. Central corneal thickness in patients with meibomian gland dysfunctiona. Clin Exp Optom 2021; 94:464-7. [DOI: 10.1111/j.1444-0938.2011.00631.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- İlknur Akyol‐salman
- Atatürk University Faculty of Medicine, Department of Ophthalmology, Erzurum, Turkey. E‐mail:
| | - Sedat Azizi
- Atatürk University Faculty of Medicine, Department of Ophthalmology, Erzurum, Turkey. E‐mail:
| | - Uğur Mumcu
- Atatürk University Faculty of Medicine, Department of Ophthalmology, Erzurum, Turkey. E‐mail:
| | - Osman Öndaş
- Atatürk University Faculty of Medicine, Department of Ophthalmology, Erzurum, Turkey. E‐mail:
| | - Orhan Baykal
- Atatürk University Faculty of Medicine, Department of Ophthalmology, Erzurum, Turkey. E‐mail:
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Zhang K, Zhao L, Zhu C, Nan W, Ding X, Dong Y, Zhao M. The effect of diabetes on corneal endothelium: a meta-analysis. BMC Ophthalmol 2021; 21:78. [PMID: 33568093 PMCID: PMC7874671 DOI: 10.1186/s12886-020-01785-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 12/21/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This research was conducted with the aim to determine the effect of diabetes mellitus on corneal endothelial cells. METHODS The terms: ("diabetes mellitus" or "diabetes" or "diabetic") and ("corneal endothelium" or "cornea" or "Corneas") searched in Pubmed, Embase, Cochrane, and Web of science until August 2019. The included types of studies contained observational studies. The standard mean difference (SMD) which was deemed as main size effects for continuous data was calculated by means and standard deviations. The data on corneal endothelial cell density (ECD), mean cell area (MCA), cell area variation coefficient (CV) and percentage of hexagonal cells (HEX) included in the study were collected and analyzed using stata15.1. RESULTS The final 16 cross-sectional studies and 2 case-control studies were included for the meta-analysis. Meta-analysis revealed that diabetes mellitus could reduce ECD (SMD = - 0.352, 95% CI -0.538, - 0.166) and the HEX (SMD = - 0.145, 95% CI -0.217, - 0.074), in addition to increasing CV (SMD = 0.195, 95% CI 0.123, 0.268). Nevertheless, there was no statistically significant differences observed when combining MCA (SMD = 0.078, 95% CI -0.022, 0.178). In subgroup analysis, Type 2 diabetes patients owned less corneal ECD (P < 0.05). Moreover the same results also found during the subgroup form Asia, Europe and American. The meta-regression revealed the type of diabetes mellitus might be contributing to heterogeneity. (P = 0.008). The results indicated a significant publication bias for studies, with combined CV (Begg's test, P = 0.006; Egger's test, P = 0.005) and merged combined HEX (Begg's test, P = 0.113; Egger's test, P = 0.024). CONCLUSIONS As indicated by meta-analysis, diabetes mellitus could cause a detrimental effect on corneal endothelium health. Diabetes mellitus contributed to the instability of corneal endothelium during the analysis. Therefore, further research is considered necessary to confirm our research results. TRIAL REGISTRATION CED 42019145858 .
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Affiliation(s)
- Kaikai Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China
| | - Liangliang Zhao
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China
| | - Chao Zhu
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China
| | - Weijin Nan
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China
| | - Xinfen Ding
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China
| | - Yuchen Dong
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China
| | - Meisheng Zhao
- Department of Ophthalmology, The Second Affiliated Hospital of Jilin University, Changchun, 13000, China.
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A systematic review on the impact of diabetes mellitus on the ocular surface. Nutr Diabetes 2017; 7:e251. [PMID: 28319106 PMCID: PMC5380897 DOI: 10.1038/nutd.2017.4] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/10/2016] [Accepted: 11/14/2016] [Indexed: 12/27/2022] Open
Abstract
Diabetes mellitus is associated with extensive morbidity and mortality in any human community. It is well understood that the burden of diabetes is attributed to chronic progressive damage in major end-organs, but it is underappreciated that the most superficial and transparent organ affected by diabetes is the cornea. Different corneal components (epithelium, nerves, immune cells and endothelium) underpin specific systemic complications of diabetes. Just as diabetic retinopathy is a marker of more generalized microvascular disease, corneal nerve changes can predict peripheral and autonomic neuropathy, providing a window of opportunity for early treatment. In addition, alterations of immune cells in corneas suggest an inflammatory component in diabetic complications. Furthermore, impaired corneal epithelial wound healing may also imply more widespread disease. The non-invasiveness and improvement in imaging technology facilitates the emergence of new screening tools. Systemic control of diabetes can improve ocular surface health, possibly aided by anti-inflammatory and vasoprotective agents.
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Al Houssien AO, Al Houssien RO, Al-Hawass A. Magnitude of diabetes and hypertension among patients with Dry Eye Syndrome at a tertiary hospital of Riyadh, Saudi Arabia - A case series. Saudi J Ophthalmol 2017; 31:91-94. [PMID: 28559720 PMCID: PMC5436380 DOI: 10.1016/j.sjopt.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/02/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose To study the magnitude of chronic diseases among patients suffering from Dry Eye Syndrome (DES) and compare them with published findings in the literature. Methods Patients diagnosed in 2016 suffering from DES based on presenting symptoms and findings of ocular examination were included in this study. The demographic information included age and gender. Chronic diseases among them were identified through case records, assessment and ongoing medications. Results This case series had 62 patients (58% males) of DES. The mean age was 60.2 ± 16.6 years. The prevalence of hypertension, dyslipidemia and diabetes among them was 48.5% (95% confidence interval (CI) 31.5–65.5), 55.9% (95% CI 40.1–71.7) and 47.1% (95% CI 29.8–64.4) respectively. The rate of thyroid diseases (16.2%), renal diseases (6.5%), and liver diseases (6.7%) was not significant in this series. Conclusions This series in central Saudi Arabia suggests that the magnitude of chronic diseases such as diabetes, hypertension, obesity and dyslipidemia seems to be higher in patients with DES compared to the population.
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Affiliation(s)
- Abdullah Omar Al Houssien
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Rana Omar Al Houssien
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Al-Hawass
- Division of Ophthalmology Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Differences in Central Corneal Thickness between Spectral Domain-Optical Coherence Tomography and Ultrasound Pachymetry in Patients with Dry Eye Disease. J Ophthalmol 2016; 2016:2623719. [PMID: 27375899 PMCID: PMC4916283 DOI: 10.1155/2016/2623719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/17/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose. To compare central corneal thickness (CCT) values via Spectral Domain-Optical Coherence Tomography (SD-OCT) and ultrasonic pachymetry in patients with severe dry eye disease (DED) to determine the level of agreement between these 2 methods. Methods. The paired samples t-test was used to compare CCT values in severe DED patients. Matching analysis between methods was performed using intraclass correlation coefficient (ICC). Intrasession reliability of the measurement methods was calculated via the concordance correlation coefficient (CCC), variation equivalent, and Pearson's correlation coefficient. The Bland-Altman procedure was used to graphically represent the differences between CCT values. Results. The study included 56 eyes of 24 female and 4 male patients. Mean age of the patients was 50.9 ± 11.3 years. Mean CCT via Cirrus SD-OCT was 523.82 ± 30.98 μm versus 530.050 ± 31.85 μm via ultrasonic pachymetry (paired samples t-test, P < 0.001). The Bland-Altman plot showed good agreement between the examiners. The ICC for repeatability was 0.974. The CCC between the 2 methods' CCT values was 0.973. The variation equivalent was 0.976 and Pearson's correlation coefficient was 99.3%, which also indicated high correlation between the 2 methods' measurements. Conclusions. The present findings show that in patients with severe DED Cirrus SD-OCT provides reliable intraobserver CCT values.
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Relationship of change in central corneal thickness to visual field progression in eyes with glaucoma. Graefes Arch Clin Exp Ophthalmol 2013; 251:1593-9. [DOI: 10.1007/s00417-013-2295-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 02/20/2013] [Accepted: 02/24/2013] [Indexed: 10/27/2022] Open
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Matsuoka M, Ogata N, Matsuyama K, Yoshikawa T, Takahashi K. Intraocular pressure in Japanese diabetic patients. Clin Ophthalmol 2012; 6:1005-9. [PMID: 22815643 PMCID: PMC3399389 DOI: 10.2147/opth.s33131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To determine whether the intraocular pressure (IOP) in diabetic patients is significantly different from that in nondiabetic patients. Methods The medical records of all patients who were initially examined in the Department of Ophthalmology, Kansai Medical University, Takii Hospital were reviewed. At the initial examination, patients had a detailed interview and underwent a comprehensive ophthalmic examinations. All patients were over 20 years of age and did not have glaucoma. Results A total of 703 patients were evaluated. The mean (±standard error) IOP of the diabetic patients was 15.5 ± 0.2 mmHg (n = 206), and was significantly higher than the 14.0 ± 0.1 mmHg (n = 497) in the nondiabetic patients (P < 0.0001). The IOP was negatively correlated with age (r = −0.202; P = 0.024) in the diabetic patients and was weakly but significantly correlated with the glycosylated hemoglobin (HbA1c) level (r = 0.240; P = 0.015) in the group with diabetic retinopathy. Conclusion The significantly higher IOP in diabetic patients and positive correlation of IOP with HbA1c levels in patients with diabetic retinopathy indicate that IOP in diabetic patients is higher, especially in those with poor control of diabetes.
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Affiliation(s)
- Masato Matsuoka
- Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka
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