Early detection of cataract in type 1 diabetes: A cross-sectional study using Scheimpflug imaging

To compare lens densitometry measured by Scheimpflug imaging in adults with type 1 diabetes mellitus, T1DM, and healthy controls, and to assess the associations of lens density with age, diabetes duration, and glycated haemoglobin, HbA1c.

This cross-sectional study included 52 adults with T1DM and 53 healthy controls examined at St Anne's University Hospital Brno between January and December 2021. All participants underwent history taking, slit-lamp examination under pharmacological mydriasis, and Scheimpflug-based lens densitometry using Pentacam HR (Oculus, Wetzlar, Germany). Statistical analysis included the Shapiro-Wilk test, the Mann-Whitney test, simple linear regression, and an exploratory multivariable linear regression model in the diabetic cohort.

Lens densitometry was significantly higher in the T1DM group than in controls (P<0.001). Lens density also increased significantly with age in the whole cohort (P<0.001). In the diabetic cohort, longer diabetes duration was associated with higher lens density in univariable analysis (P=0.02). Median HbA1c was not significantly associated with lens density in univariable analysis (P=0.17). Because age and diabetes duration may be interrelated, an exploratory multivariable model including age, diabetes duration, and HbA1c was additionally performed. In this model, age remained the dominant factor, whereas interpretation of the other covariates remained cautious because of sample size limitations and collinearity.

Scheimpflug-based lens densitometry identified lower lens transparency in adults with T1DM than in healthy controls. The method appears useful as an objective quantitative adjunct for detecting early lenticular changes, but the findings should be interpreted with consideration of age and other potential confounding factors.