%0 Journal Article
%T Evaluation of Corneal Endothelium in Children and Adolescents with Type 1 Diabetes Mellitus
%A Beata Urban
%A Dorota Raczy¨½ska
%A Alina Bakunowicz-£¿azarczyk
%A Krystyna Raczy¨½ska
%A Ma£¿gorzata Kr£¿towska
%J Mediators of Inflammation
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/913754
%X Purpose. To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. Materials and Methods. The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ¡À 3.06 years versus 14.58 ¡À 2.01 years in the control group. The mean duration of diabetes was 8.02 ¡À 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P. Results. The mean ECD in diabetic eyes was 2435.55 ¡À 443.43£¿cells/mm2 and was significantly lower than in control group (2970.75 ¡À 270.1£¿cells/mm2). The mean CCT was 0.55 ¡À 0.03£¿mm in diabetic group versus 0.53 ¡À 0.033£¿mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level. Conclusions. ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT. 1. Introduction The corneal endothelium is a single layer of uniformly sized cells with hexagonal shape. Their amount decreases by approximately 0.5%-0.6% (100¨C200 cells) per year [1]. The endothelial cell dysfunction is observed in myopia and in contact lens wearers [2, 3]. The decreasing number of endothelial cells can also be a result of a surgical injury related to the opening of the anterior chamber [4]. Many studies have shown that even minor changes in the morphology of the endothelial cells may manifest in the disturbances in the tightness of the endothelial barrier. It has been demonstrated that human corneal endothelial cells have mitotic ability in vitro, but in vivo they do not exit the cell cycle but are arrested in G1 phase [5]. Loss of cells is compensated through the expanding and spreading of cells, which over time results in a lack of tightness and corneal oedema. Prevention of the corneal endothelium dysfunction, its early detection and immediate treatment are therefore crucial, especially if the problem concerns young patients. Noncontact specular microscopy, which evaluates endothelial morphology quickly and easily, can be especially useful with children. One of the conditions, which affect the cornea is diabetes. There are many reports concerning the analysis of the corneal endothelium in adults with type 1 and type 2 diabetes [6¨C9]; however, there
%U http://www.hindawi.com/journals/mi/2013/913754/