ABSTRACT
Background: Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma. All forms of diabetic eye disease have the potential to cause severe vision loss and blindness. Animal studies have also shown that corneal endothelial cells in diabetic rats have morphological abnormalities. These abnormalities include a decrease in endothelial cell density (CD) and hexagonality, as well as increased polymegathism, polymorphism, and central corneal thickness (CCT). Aim: To compare corneal endothelial cell changes such as endothelial cell density (ECD) percentage of polymegathism (coefficient of variation) along with central corneal thickness (CCT) in patients with type 2 diabetes mellitus with age-matched control subjects. Materials and methods: Totally 40 patients among them 20 Patients (40 eyes) with type 2 DM and 20 control (non-diabetic) subjects (40 eyes). The corneal endothelial structure and CCT were examined in all eyes by noncontact specular microscopy using KONAN MEDICAL Specular D. Sundararajan, N. Sathish Kumar. Specular microscope as an accurate tool for analysing corneal endothelial cell changes in patients with type 2 diabetes mellitus at tertiary care hospital set up in Kanchipuram District. IAIM, 2017; 4(10): 188-193. Page 189 Microscope. The endothelial structure was studied for ECD, the coefficient of variation of cell area (CV), and percentage of hexagonal cells. Results were analyzed accordingly. Results: In our study, 20 patients (40) eyes with HbA1c were 8.5% (Group I) and 20 patients (40) eyes with HbA1c. 4.5% (Group II) Endothelial cell density was significantly lower in the diabetic cornea than in control group (P=0.34). In (Group I) CV was higher in the diabetic cornea (P=0.003). The diabetic cornea group had a lower percentage of hexagonal cells than the control group (II), but the difference was not statistically significant (P=0.503). Also, the diabetic cornea was thicker in (Group I) than the control group, (Group II) but not statistically significant (P=0.210). Conclusion: This study documented that type 2 DM causes a significant reduction of endothelial cell density and increased coefficient of variation (polymegathism). Also, the diabetic cornea has increased central corneal thickness and a lower percentage of hexagonal cells than normal subjects, but without statistical significance
ABSTRACT
Background: Intermediate uveitis is a form of uveitis localized to the vitreous and peripheral retina. Primary sites of inflammation include the vitreous of which other such entities as pars planitis, posterior cyclitis, and hyalitis are encompassed. Intermediate uveitis may either be an isolated eye disease. Involvement of the corneal endothelium during uveitis has not been extensively studied even though it might participate in or constitute a target of ocular inflammation. Formation of keratic precipitates (KP) is a characteristic finding in several forms of uveitis. Aim: The aim of this prospective study was to examine the vicinity of keratic precipitates in infectious and non-infectious uveitis by specular microscopy. Materials and methods: Patients with infectious and non-infectious uveitis in any activity level and presence of keratic precipitates were enrolled. A noncontact specular microscope was used to capture endothelial images in the vicinity of keratic precipitates. The automated morphometric analysis was done for cell size, cell density and cells coefficient of variation. Statistical comparisons were made between the infectious and non-infectious groups. Results: Totally 50 patients were enrolled in this study, 30 (64%) eyes presented infectious uveitis, 20 (36%) non-infectious uveitis and 1 (3%) eye were excluded due to the impossibility to obtain a specular image. The mean cell density estimated was 2,628 ± 204 cells/mm2 in the infectious group and 2,622 ± 357 cells/mm2 in the non-infectious group. The mean cellular area in the infectious and non-infectious group was respectively 385 ± 31 µm2 and 390 ± 60 µm2 . The coefficient of variation (%) of the cellular area in the vicinity of keratic precipitates was 26.36 ±3.44 in infectious and 27.69 ± D. Sundararajan, N. Sathish Kumar, S. Veluchamy. Specular microscopic study of cornea in infectious and noninfectious uveitis in rural population of south India. IAIM, 2017; 4(10): 111-116. Page 112 4.61 in the non-infectious group. The differences between the groups were not statistically significant (P<0.005 / Mann-Whitney test) for the three morphologic variables. Conclusion: The clinical applicability of specular microscopy in patients with uveitis can be a useful tool to evaluate the corneal endothelium in the presence of keratic precipitates, however, the handicap of the specular image formation might not be discarded in some cases. The differences found were not clinically meaningful between the infectious and non-infectious groups, however the uveitis in various degrees of intraocular inflammation
ABSTRACT
Background: Myopia is a common pathologic change of the eye, especially in Asian countries undergoing rapid development. It is known that Asian people have a higher prevalence of myopia. High levels of myopia are associated with increased risk of cataract, posterior vitreous detachment, retinal tears and retinal detachment, increased risk of choroidal neovascularization, and myopic macular degeneration. Aim: To describe the corneal endothelial density and morphology in patients of low and moderate myopic in rural south Indian population and the relationship between endothelial cell parameters and other factors. Materials and Methods: Totally 100 patients were included. Noncontact specular microscopy was performed after taking a history and testing the visual acuity, intraocular pressure measurement, Schirmer’s test and routine eye examination by slit lamp microscope. The studied parameters included mean endothelial cell density (MCD), the coefficient of variation (CV), and percentage of hexagonality. Results: In low myopic eyes the MCD was 2892. 0±146.2/mm2 , the mean CV was 38.4± 0.4 and the mean hexagonal appearance of the cell was 53.9± 0.9%. In moderate myopic eyes, the MCD was 35716± 142.0 mm2 , the mean CV was 37.9± 3.4% and mean the hexagonal appearance of the cell was N. Sathish Kumar, D. Sundararajan, S. Veluchamy. Assessment of corneal endothelial cell density and morphology in low and moderate myopic eyes in rural south Indian population. IAIM, 2017; 4(10): 93-96. Page 94 59.83± 3.6. There were statistically significant differences in MCD (p<0.000) and hexagonal appearance of the cell (p<0.005) between low and moderate myopic eyes. Conclusion: The normative data of the corneal endothelium of eyes indicated that statistically, MCD decreased significantly with age. Previous studies have reported no difference in MCD, the percentage of CV, and percentage of hexagonality between genders. Nevertheless, significantly different percentages of CV between genders were presented in this study.