Corneal and Lens Clarity in Children With Type 1 Diabetes
American Journal of Ophthalmology, September 2017
Diabetic retinopathy (DR) is the chief ocular defect in patients with type 1 diabetes mellitus (DM). However, vision- threatening DR is rare in children, regardless of control or duration of diabetes. Tekin et al. sought to determine whether the impaired glucose metabolism intrinsic to diabetes is associated with effects on corneal or lens clarity in children with type 1 disease. They found that, relative to healthy subjects, children with type 1 DM had poorer lens clarity and greater lens thickness.
For this multicenter cross-sectional study, the researchers included 56 patients with well-controlled type 1 DM (mean age, 13.1 years) and 51 healthy controls (mean age, 12.2 years). Children with lens opacities or cataract were excluded. Duration of disease and hemoglobin Alc levels were documented for patients with DM. The Pentacam HR imaging system was utilized to obtain corneal densitometry measurements for all participants. Lens densitometry and thickness were measured using the same device, after pupillary dilation.
In all concentric zones and layers, corneal densitometry values were similar for the 2 study groups. Significant between-group differences were noted in mean values for average and maximum lens densitometry and in mean lens thickness. Among children with DM, the mean disease duration was 7.05 years and the mean hemoglobin Alc level was 6.36%. Lens densitometry values correlated strongly with DM duration but not with hemoglobin Alc level.
The authors speculated that swelling of the lens, due to elevated activity of the polyol pathway and nonenzymatic glycation of lens proteins, may contribute to the deficient lens clarity and unusual lens thickness in children with type 1 DM. Therefore, it is reasonable to surmise that diabetes plays a role in these lens abnormalities. Comprehensive longitudinal studies are warranted to fully elucidate the lens defects linked to type 1 DM.
The original article can be found here.