Corneal thickness and endothelial cell density in children with type 1 diabetes mellitus
Sheldon Ignatius Fernandes1, Shubha Nagpal1
1Department of Ophthalmology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India.
Insights
Type 1 diabetes in children increases corneal thickness and decreases endothelial cell density. While age impacts cell density, diabetes duration and HbA1c levels do not show a significant correlation with these corneal changes.
Area of Science:
- Ophthalmology
- Endocrinology
- Pediatrics
Background:
- Type 1 diabetes (T1D) can affect various organs, including the eyes.
- The pediatric corneal endothelium's response to T1D is not well-understood.
- Assessing corneal changes in diabetic children is crucial for early detection and management.
Purpose of the Study:
- To investigate the impact of T1D on the corneal endothelium in children.
- To compare corneal parameters between T1D patients and healthy controls.
- To explore correlations between corneal changes and diabetes risk factors (age, duration, HbA1c).
Main Methods:
- Prospective cross-sectional study involving 50 children with T1D and 50 age-matched controls.
- Specular microscopy (Topcon SP-1P) used to measure central corneal thickness (CCT) and endothelial cell density (CD).
- Data collected on patient age, diabetes duration, and hemoglobin A1c (HbA1c) levels.
Main Results:
- Children with T1D exhibited significantly higher CCT (525.16 ± 33.14 μm) compared to controls (513.44 ± 29.46 μm; P=0.015).
- Endothelial CD was significantly lower in T1D patients (3039.64 ± 292.84 cells/mm²) versus controls (3360.41 ± 268.04 cells/mm²; P<0.001).
- A significant negative correlation was observed between endothelial CD and patient age (P=0.008), but not with diabetes duration or HbA1c.
Conclusions:
- Pediatric T1D is associated with increased CCT and decreased endothelial CD.
- Endothelial cell density declines with age in diabetic children.
- Diabetes duration and HbA1c levels did not significantly influence corneal endothelium parameters in this cohort.
Background:
The aim of this study was to detect the effect of diabetes on the corneal endothelium in patients of Type 1 diabetes in the pediatric age group and to compare them with age-matched controls. Further, it was proposed to establish any correlation between these changes and risk factors of diabetes, viz., age, duration of diabetes, and hemoglobin A1c (HbA1c) values.
Materials And Methods:
This was a prospective cross-sectional study. Fifty children with Type 1 diabetes, between the ages of 7 and 17 years (average, 12.16 ± 2.63 years), and fifty healthy age-matched controls (average 12.28- ±3.00 years) were examined. The central corneal thickness (CCT) and endothelial cell density (CD) were assessed by the Topcon SP-1P specular microscope. The duration of diabetes (average, 3.91 ± 1.65 years) and the HbA1c values (average, 10.92 ± 2.28) were also noted.
Results:
The average CCT in the diabetics was 525.16 ± 33.14 μ and in the controls 513.44 ± 29.46 μ. This was significantly higher (P = 0.015). The average endothelial CD in the diabetics was 3039.64 ± 292.84 cells/mm2 and in the nondiabetics 3360.41 ± 268.04 cells/mm2. This was significantly lower (P < 0.001). A significant correlation was found between the endothelial CD and age of the diabetic patients (P = 0.008). However, there was no significant correlation between the endothelial CD and the CCT with either duration of diabetes or HbA1c.
Conclusions:
A significant decrease in the endothelial CD and increase in the CCT occurs in children and adolescents with Type 1 diabetes. With the age of the diabetic patients, the endothelial CD significantly reduces. However, duration of diabetes and HbA1c do not affect these values.
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