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Examination of the ocular surface in patients with diabetes mellitus and glaucoma

Valeri Sheherov


Purpose: To demonstrate and analyse the microstructural changes of the cornea in eyes with glaucoma of
patients suffering diabetes, using laser scanning confocal microscopy (LSCM).

Methods: The study included both eyes of ten patients with diabetes, examined clinically, and by non-contact optical pachymetry and laser scanning confocal microscopy (LSCM). Results were compared with age matching subjects without eye disease (control group n=20 eyes). All participants had a complete eye examination. The collected data were blindly analyzed by two independent researchers. Qualitative and quantitative analysis was performed as previously described by our group (ref).

Results: The average central corneal thickness among patients was 541±27μm which differed from the normal subjects (560±15 μm). The average density of cells in the basal epithelial layer was 5846±750 cells/ mm² in comparison to the controls (6000±350 cells/mm²) . The average density of endothelial cells was 2694±300 cells/mm², and were lower than the controls (2790±239 cells/mm²). In some eyes they showed visible polimegatism and polymorphism. Specific particles of varying size and shape considered to be deposits were found in 35% of eyes with density of 94 particles/ mm². Those were not identified in controls.

Conclusions: Laser scanning confocal microscopy in vivo allows non-invasive, repeatable identification of microstructural changes in patients with diabetes and glaucoma. Perhaps the most characteristic feature is decreased density of the nerves in combination with cell loss, which potentially complicates the prognosis in following medical and surgical treatments. We are still to elucidate the nature of the particles highlighted in one-third of our diseased eyes.


diabetes; glaucoma; laser scanning confocal microscopy; cornea


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About The Author

Valeri Sheherov
Medical University of Varna

Department of Ophthalmology and Visual Science

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