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Comparative study of corneal endothelial morphology and central corneal thickness in diabetic and non-diabetic patients at tertiary care centre

BMC Ophthalmol. 2025 Nov 13;25(1):640. doi: 10.1186/s12886-025-04505-x.

ABSTRACT

BACKGROUND: Diabetes mellitus is a chronic condition that affects various organs, including the eyes. Corneal endothelial dysfunction, a key factor in ocular health, can be influenced by long-term diabetes. Early detection of corneal changes, such as central corneal thickness (CCT), endothelial cell density (CD), coefficient of variation (CV), and hexagonality (HEX), may provide insights into diabetic ocular complications. This study evaluates the differences in corneal endothelial parameters between diabetic and non-diabetic individuals.

AIM: To compare the corneal endothelial parameters, including CCT, CD, CV, and HEX, in diabetic patients and non-diabetic controls, and assess the correlation between these parameters and the duration of diabetes.

METHODOLOGY: This cross-sectional comparative study was conducted at a tertiary eye care hospital with 100 eyes from 50 diabetic patients and 100 eyes from 50 age-matched non-diabetic controls. All participants underwent a comprehensive ophthalmological evaluation, including intraocular pressure measurement, refraction, best corrected visual acuity, and slit-lamp biomicroscopy. Corneal endothelial imaging was performed using non-contact specular microscopy to assess CCT, CD, CV, and HEX. Statistical analysis was performed using SPSS, with a p-value of < 0.05 considered statistically significant.

RESULTS: In our study, diabetic patients had significantly higher central corneal thickness (CCT) in both eyes (OD: 593.9 ± 60.2 μm; OS: 610.5 ± 60.7 μm) compared to non-diabetics (OD: 550.9 ± 66.1 μm; OS: 593.9 ± 60.2 μm). Hexagonality (HEX) was lower in diabetics (OD: 43.2 ± 12.5%; OS: 42.3 ± 15.8%) vs. non-diabetics (OD: 52.1 ± 10.5%; OS: 41.7 ± 11.9%). HbA1C was significantly higher in diabetics (7.31 ± 1.13%) than non-diabetics (5.48 ± 0.67%; p = 0.012). Cell density (CD) and coefficient of variation (CV) showed no significant differences.

CONCLUSION: Diabetic patients exhibit significant changes in corneal endothelial parameters, which may indicate early endothelial dysfunction. Regular monitoring of these parameters could provide valuable insights into the ocular health of diabetic individuals.

PMID:41233814 | DOI:10.1186/s12886-025-04505-x

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