Corneal biomechanical properties and intraocular pressure assessment in pediatric type 1 diabetes mellitus: A...

PurposeTo evaluate corneal biomechanical properties in pediatric patients with type 1 diabetes mellitus (DM) using Corvis ST and compare them with those of age- and sex-matched healthy controls.MethodsThis retrospective, cross-sectional study included 24 eyes of 24 children with type 1 DM (group 1) and 21 eyes of 21 healthy controls (group 2). None of the patients had diabetic retinopathy. Intraocular pressure (IOP) measured by Goldmann applanation tonometer (IOP-GAT) and corneal biomechanical parameters obtained with Corvis ST were compared between groups. Correlations between corneal biomechanical parameters and diabetes-related variables, including glycated hemoglobin (HbA1c) levels and disease duration, were also evaluated.ResultsChildren with type 1 DM demonstrated significantly higher IOP-GAT and biomechanically corrected IOP (bIOP) values compared with healthy controls (p = 0.002 and p = 0.022). Central corneal thickness (CCT) was also significantly increased in the diabetic group (p < 0.001). Corvis ST analysis revealed prolonged Applanation 1(A1) time, reduced deformation amplitude (DA), decreased Applanation-2 (A2) velocity, increased highest concavity (HC) radius, and reduced peak distance (PD) in group 1 compared to group 2 (all p < 0.05). Stiffness parameter at the first applanation (SP-A1) values were significantly higher in group 1 (p < 0.001), while Corvis biomechanical index (CBI) values were lower (p = 0.005). No significant differences were observed in Tomographic and biomechanical index (TBI) or Ambrósio relational thickness - horizontal (ARTh) values between groups. HbA1c levels and disease duration showed no significant correlation with corneal biomechanical parameters, although a non-significant trend toward a negative correlation between HbA1c and TBI was observed (Spearman's rho = -0.270, p = 0.073).ConclusionChildren with type 1 DM show early alterations in corneal biomechanics and higher IOP (both IOP-GAT and bIOP), even in the absence of diabetic retinopathy. These findings suggest that corneal involvement occurs early in pediatric diabetes and support the value of corneal biomechanical assessment which may influence IOP measurements and should be carefully considered when assessing and interpreting IOP in this population.