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Refractive changes in diabetic patients during intensive glycaemic control
F Okamoto1, H Sone, T Nonoyama
1Department of Ophthalmology, Tsukuba University Hospital, Japan. fumiki@iea.att.ne.jp
The British Journal of Ophthalmology
|September 27, 2000
Summary
Rapidly lowering blood sugar in patients with severe hyperglycemia can cause temporary farsightedness (hyperopia). The degree of this refractive error is linked to how quickly glucose levels decrease, suggesting lens changes are responsible.
Area of Science:
- Ophthalmology
- Endocrinology
- Metabolic Disorders
Background:
- Severe hyperglycemia in patients with persistent diabetes can lead to transient refractive errors.
- Understanding these changes is crucial for managing diabetic eye complications.
Observation:
- A prospective study evaluated 28 eyes of patients undergoing intensive glycemic control.
- Ophthalmological examinations and A-mode scan ultrasonography were performed regularly.
Findings:
- All patients developed transient hyperopia, peaking around 10 days, with a maximum change of 1.47 D.
- Hyperopic shift correlated positively with plasma glucose, HbA1c, and the rate of glucose reduction.
- No significant changes in corneal curvature, axial length, or anterior chamber depth were noted.
Implications:
- The rate of plasma glucose reduction significantly influences the degree of transient hyperopia.
- Changes in the refractive index of intraocular tissues, particularly the lens, are likely the cause.
- This finding aids in predicting and managing visual disturbances during diabetes treatment.