Corneal endothelial cell morphology and optical coherence tomography findings in children with type 1 diabetes mellitus

Eur J Ophthalmol. 2023 May;33(3):1331-1339. doi: 10.1177/11206721221145983. Epub 2022 Dec 21.

Abstract

Purpose: To evaluate central macular thickness, retinal nerve fibre layer thickness, corneal endothelial cell density and central corneal thickness in children with Type 1 Diabetes Mellitus (DM).

Methods: Thirty children with Type 1 DM and 30 age-matched children as controls were examined. Central macular thickness (CMT) and four quadrants of retinal nerve fibre layer thickness (RNFLT) were measured by optical coherence tomography (OCT), while endothelial cell density (ECD), coefficient of variation in cell size (CV), hexagonality (HEX) and central corneal thickness (CCT) were measured by noncontact specular microscopy.

Results: The mean ECD was 2810.77 ± 273.47 cells/mm2 and the mean hexagonality ratio was 49.77 ± 13.2 both were significantly lower (p < 0.001, p = 0.037 respectively) in the diabetic group compared to the control group. The mean CV was 37.6 ± 7.27, it was significantly higher (p = 0.024) in the diabetic group than the control group. The mean corneal thickness was greater in the DM group than the controls, but the difference was not significant (p = 0.176). There were no significant differences in CMT or RNFLT between the two groups. There was a negative correlation between the HbA1c levels and the thickness of the superior quadrants of RNFL (r = -0.406, p = 0.026). The duration of diabetes had no significant correlations with the corneal and retinal parameters.

Conclusion: The diabetic children had changes in corneal endothelial morphology and there was a negative correlation between HbA1c levels and superior quadrant of RNFLT.

Keywords: central corneal thickness; endothelial morphology; macular thickness; noncontact specular microscopy; type 1 diabetes mellitus.

MeSH terms

  • Cell Count
  • Child
  • Cornea
  • Diabetes Mellitus, Type 1* / complications
  • Endothelial Cells
  • Endothelium, Corneal
  • Glycated Hemoglobin
  • Humans
  • Tomography, Optical Coherence / methods

Substances

  • Glycated Hemoglobin