Researchers recently found that keratopathy is an important complication of type 2 diabetes and, as diabetic retinopathy progresses (DR), so do corneal alterations.

The study included 195 diabetic patients and 100 healthy controls. A team took corneal endothelial measurements, serum fasting glucose levels, hemoglobin A1c levels, creatinine levels and urinary albumin-to-creatinine ratios to further subdivide diabetic patients into three groups according to the presence and stage of DR. They then compared the specular microscopy findings and central corneal thicknesses of all patients.

The investigators discovered that the endothelial cell density (ECD) and hexagonal cell ratio were significantly lower, while the average cell size and central corneal thickness were significantly higher in diabetic patients. With the presence and advancement of DR, they noted that the ECD and hexagonal cell ratio decreased, while the average cell size and central corneal thickness increased. They observed a significant negative correlation between ECD and diabetes duration. They added that hemoglobin A1c level, urinary albumin-creatinine ratio and average cell size positively correlated with these parameters.

“Keratopathy should be evaluated more cautiously in diabetic patients,” the study authors concluded in their paper. “Larger, prospective studies are warranted to define the role of keratopathy in the long-term outcomes of diabetic patients.”

Taşlı NG, Icel E, Karakurt Y, et al. The findings of corneal specular microscopy in patients with type-2 diabetes mellitus. BMC Ophthalmol. June 3, 2020. [Epub ahead of print].