Effect of Diabetes Mellitus on Central Corneal Thickness and Endothelial Counts in Ethnic Groups in Malaysia

1. Effect of Diabetes Mellitus on Central Corneal Thickness and Endothelial Counts in Ethnic Groups in Malaysia Angela Loo, MD; Soon Lek Yap, MD; Wan Mariny, MD; Yu Ming Ong, MD; Visvaraja Subrayan1 M.D.; The authors have no financial interest in any material used in this study Ophthalmology Department, University of Malaya World Cornea Congress VI, Boston 2010

2. Purpose • To investigate the effect of Type 2 DM on endothelial cell count and central corneal thickness among Chinese, Malay and Indian patients in Malaysia World Cornea Congress VI, Boston 2010

3. Methods • Hospital based, cross sectional study. • Screening was done daily to look for patients with Type II Diabetes Mellitus, age > 21 years, without any previous ocular or surgical history. • Data collection was by patient interview, ocular examination, and blood samples for analysis of diabetic control. • Controls were randomly selected. World Cornea Congress VI, Boston 2010

4. Methods • Examination of the fundus was performed at the slit lamp using an indirect 90D or 78D lens and retinopathy status was based on the Early Treatment Diabetic Retinopathy Study (EDTRS) • Specular microscopy was performed using the non-contact TOPCON SP 3000 P microscope • Five central endothelial photographs of each eye were obtained on both eyes of all patients and the mean numbers of endothelial cell density was used for statistical analysis. World Cornea Congress VI, Boston 2010

5. Results • An equal amount of the number of patients of different races and gender were included in the study World Cornea Congress VI, Boston 2010

6. Results Comparison of central corneal thickness, CV of endothelial cell size, percentage of hexagonal cells and corneal endothelial cell density between diabetics and non diabetics World Cornea Congress VI, Boston 2010

7. Results Mean Central Corneal Thickness among 3 Ethnic Groups in Diabetics and Non Diabetics World Cornea Congress VI, Boston 2010

8. Results Mean Endothelial Cell Count among 3 Ethnic Groups in Diabetics and Non Diabetics World Cornea Congress VI, Boston 2010

9. Conclusion • Significant difference in central corneal thickness among Malay, Chinese and Indian in which Chinese has the thickest central corneal thickness followed by Malay and Indian. However, there was no significant difference in endothelial cell density among the three ethnic groups. • Central corneal thickness in diabetics was significantly thicker compared to non diabetics. • Knowledge of ethnic differences will help ophthalmologists manage their patients better, with respect to the prevention of complications related to ocular surgery. World Cornea Congress VI, Boston 2010

10. References • Rajesh P, K.N.Ranganath, P Suresh et al. Corneal endothelium count and thickness in diabetes mellitus. Int J Diab Ctries. 2006;26:24-26. • Mamoru Matsuda, Richard W, Henry F et al. Comparison of corneal endothelium in an American and a Japanese population. 1985;103:68-70. • Kenji Inoue, Satoshi Kato, Yuji Inoue et al. The corneal endothelium and thickness in type 11 diabetes mellitus. Jpn J Ophthalmology 2002;46:65-69. • Daniel H, Tien Y. Wong, Wan LW et al. Diabetes, hyperglycaemia and central corneal thickness: The Singapore Malay eye study. Ophthalmology 2008;115:964-968 World Cornea Congress VI, Boston 2010