Corneal endothelial morphology changes in patients with proliferative diabetic retinopathy

Diabetes patients often suffer from diabetes keratopathy in the course of their illness. The examination of corneal endothelium in proliferative diabetic retinopathy (PDR) patients has important clinical significance. Here, we investigated the effect of PDR on corneal endothelial parameters.

To analyze the associations between corneal endothelial cell parameters and proliferative diabetic retinopathy (PDR).

We analyzed endothelial cell density (ECD), coefficient of variation in cell size (CV), hexagonality, and neutrophil/lymphocyte ratio (NLR) in patients with PDR and compared them with age-matched controls. The influences of duration of diabetes mellitus and level of glycosylated hemoglobin (HbA1c) were also analyzed.

The study group included 106 eyes of 106 PDR patients and 85 eyes of 85 control subjects. Significant differences were found in ECD (2,436.11 ± 222.08 cells/mm² in PDR, 2527.16 ± 191.64 cells/mm² in controls; p < 0.05), CV (41.32 ± 7.40 in PDR, 37.71 ± 5.08 in controls; p < 0.05), Hex (50.07 ± 5.32 in PDR patients, 53.29 ± 5.73 in controls; p < 0.05), and NLR (2.94 ± 1.27 in PDR, 2.12 ± 0.56 in controls; p < 0.05). In the PDR group, ECD showed a decreasing trend as age increased (p trend < 0.05), and Spearman’s correlation indicated a significant positive correlation between NLR and macular thickness (p < 0.05).

PDR had deleterious effects on the corneal endothelium. PDR patients should undergo a rigorous corneal assessment to analyze the status of endothelial health, to identify the optimal treatment.