The Relationship Between Anterior Chamber Depth and the Presence of Diabetes in the Tanjong Pagar Survey

doi:10.1016/j.ajo.2007.03.038

American Journal of Ophthalmology

Volume 144, Issue 2, August 2007, Pages 325-326

https://doi.org/10.1016/j.ajo.2007.03.038 Get rights and content

Purpose

To examine the relationships of diabetes with anterior chamber depth, axial length, and refraction.

Design

Population-based cross-sectional study.

Methods

This analysis included 943 Singapore Chinese subjects ages 40 to 81 years from the Tanjong Pagar Survey. Diabetes was determined by self-report. A-mode ultrasound was used to measure axial dimensions. Refraction was performed with an autorefractor and refined subjectively.

Results

There were 140 (11.4%) participants with diabetes. After controlling for age and gender, participants with diabetes had shallower anterior chambers (2.78 vs 2.91 mm, P = .004) and thicker lenses (4.88 vs 4.75 mm, P = .003), but similar spherical equivalent refraction (–0.38 vs –0.47 diopters [D], P = .73), axial length (23.09 vs 23.19 mm, P = .40), and vitreous chamber depth (15.52 vs 15.59 mm, P = .53).

Conclusions

In the Singapore Chinese population, persons with diabetes have shallower anterior chambers and thicker lenses than those without diabetes. Diabetes may be a risk factor for angle closure glaucoma (ACG).

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The study included 4869 (98.7 %) children out of 4933 children of the UCES, 5426 (92.0 %) out of 5899 UEMS participants, and 268 (16.3 %) out of 1526 UVOS participants. In the UEMS, shallower ACD (mean:3.14 ± 0.37 mm) correlated (multivariable analysis; r[2] = 0.57) with older age (beta: 0.08;P < 0.001), shorter body height (beta:0.03;P = 0.003), shorter axial length (beta:0.34;P < 0.001), lower corneal volume (beta:0.06;P < 0.001) and corneal refractive power (beta:0.12;P < 0.001), thicker lens (beta: 0.09;P < 0.001), higher IOP (beta: 0.03;P = 0.02), higher prevalence of angle-closure glaucoma (beta: 0.03;P = 0.003) and lower prevalence of open-angle glaucoma (beta:0.03;P = 0.007). Similar associations were found in the UCES (ACD mean:3.70 ± 0.27 mm) and UVOS (ACD mean:2.96 ± 0.56 mm).
In this population-based cohort of three generations from rural and urban Bashkortostan, ACD decreased from the children cohort (mean:3.70 ± 0.27 mm) to the adult cohort (mean:3.14 ± 0.37 mm) and to the very old cohort (2.96 ± 0.56 mm). Determinants of shallow ACD were older age and lower body height, in addition to the ocular biometric parameters of shorter axial length, lower corneal volume, corneal refractive power, and thinner lens thickness.
Modelling ocular ageing in adults with well-controlled type I diabetes
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To develop a paraxial eye model based on a previously collected cohort of adults with well-controlled type 1 diabetes mellitus (DM1) and a limited range of refractive errors.
The study used the previously published biometric data of 72 participants (Age: 41.5 ± 12.4 years) with DM1. Measurements included objective refraction, anterior and posterior corneal radii of curvatures, and internal distances. Moreover, phakometry was used to determine the lens radii of curvature and lens equivalent indices, from which the lens powers were calculated. A multivariate linear regression was performed for each biometric parameter with respect to current age (Age), the time since the onset of diabetes (T_db), and current levels of glycated hemoglobin (HbA1c). The vitreous chamber depth was determined from other distances, and lens equivalent index was chosen to balance the models. These were compared with an existing model for non-diabetic eyes.
Some dependent parameters were not affected by the independent variables (spherical equivalent, anterior corneal radius of curvature, central corneal thickness), some were affected by time since onset (the lens radii of curvatures, anterior chamber depth) and others were affected by both age and time since onset (posterior corneal radius of curvature, lens thickness, axial length). None of the dependent parameters were affected by current levels of HbA1c.
The proposed model accurately describes the age-related changes in the eyes of people with DM1. In this description the age of diabetes onset plays an important role, especially if the diabetes onset occurred during childhood.
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2017, American Journal of Ophthalmology
Citation Excerpt :
In contrast, they found no differences in the same lens parameters of the patients with type 2 DM and the controls. Saw and associates33 investigated 140 adult diabetic cases using A-mode ultrasound and found shallower anterior chambers and thicker lenses in diabetic eyes than in healthy controls. In a recent study, using optical biometry, Uzel and associates34 measured the LT, without pupil dilation, of type 1 DM patients and age-matched healthy controls.
To investigate whether abnormal glucose metabolism and duration of diabetes mellitus (DM) affected the corneal and lens clarity in children with well-controlled type 1 DM and to compare the results obtained with those in healthy children.
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This multicenter study enrolled 56 patients with DM and 51 control subjects. The duration of DM and the glycosylated hemoglobin (HbA1c) levels of the patients in the DM group were recorded. The Pentacam HR imaging system was used for corneal densitometry (12-mm corneal diameter) measurements. Furthermore, the lens densitometry and lens thickness (LT) measurements were performed after dilation of the pupils, using the same Pentacam HR device.
The corneal densitometry values were similar in all concentric zones and layers in both groups (P > .05, for all). The mean values of the average and maximum lens densitometry measurements of the 2 groups, as well as the mean LT values, were statistically significantly different (P = .021, P = .011, and P < .001, respectively). There were statistically significant correlations between the lens densitometry values and the duration of DM (P < .05, for all). Conversely, no statistically significant relationship was found between the lens densitometry values and HbA1c levels (r = 0.743; P = .084).
The children with type 1 DM had decreased lens clarity and increased LT, even in cases of well-controlled DM, without DR. It is reasonable to think that these changes might have been caused by the type 1 DM.
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2017, Archives of Gerontology and Geriatrics
This study aimed to assess the consistency between patients’ complaints and their eye diseases.
Cross-sectional study.
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  Setting: Institutional.
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  Study population: 1084 eyes of 544 elderly (≥65 years) patients.
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  Observation procedure: The eyes of the patients who had only ocular surface complaints were classified as group 1, those who wanted to renew their glasses and had no other complaints were classified as group 2, and those who complained about decrease in vision were classified as group 3.
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The frequencies of at least one newly diagnosed visually important ocular disease were 25.9%, 27.0%, and 45.3% in groups 1, 2, and 3, respectively (p < 0.001). The same frequencies were significantly higher in patients >75 years of age compared with the younger group (59.1% vs. 22.0%, p < 0.001). Although these values were statistically significant in patients ≤75 years of age (p < 0.001), they were insignificant in patients >75 years of age according to type of complaints (p = 0.773). Patients with diabetes mellitus exhibited significantly lower vision, higher rate of visually important ocular diseases, and higher intraocular pressure readings than patients without diabetes mellitus (p = 0.009, 0.015, and 0.002, respectively).
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Our study has significant clinical implications, suggesting the benefit of using a donor insertion device to reduce the initial endothelial cell damage and thus producing lower endothelial cell loss in the longer term. However, there are key differences in our study cohort compared to other study populations: our predominantly Asian population had eyes with relatively shallow anterior chambers,21,22 and there was a higher proportion of eyes with PBK in our cohort, compared to other studies with long-term DSAEK results.4,18 This underlines the need for more direct comparative studies evaluating donor insertion techniques within the same population.
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Study involved consecutive patients who underwent DSAEK with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy at a single tertiary center. Clinical data with outcomes and donor and recipient characteristics were obtained from our ongoing prospective cohort from the Singapore Corneal Transplant Study. Main outcome measures were percent endothelial cell loss and graft survival up to 3 years.
Overall percent endothelial cell loss was significantly lower in the EndoGlide group (100 eyes) compared to the Sheets glide group (119 eyes) at 1 year (16.3% ± 16.6% vs 29.5% ± 22.2%, P < .001), 2 years (23.8% ± 17.8% vs 35.7% ± 22.9%, P = .001), and 3 years (29.7% ± 20.9% vs 38.5% ± 24.1%, P = .015) postoperatively. Overall graft survival was greater in the EndoGlide compared to Sheets glide group up to 3 years postoperatively (97.9% vs 86.5%, log-rank P value = .005). In eyes with Fuchs endothelial dystrophy, endothelial cell loss was significantly lower in the EndoGlide group (3-year: 28.2% ± 17.9% vs 43.4% ± 27.1%, P = .032). In eyes with pseudophakic bullous keratopathy, the EndoGlide group had a superior graft survival compared to Sheets glide (log-rank P = .031).
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Glaucoma is a leading cause of blindness with multiple risk factors, including elevated intraocular pressure, optic nerve head ischemia, nocturnal hypotension, and systemic hypoxia. As diabetes mellitus is a major systemic cause of microvasculopathy with an increasing epidemic in the world, it is important to understand whether our diabetic patients are facing an increased risk of blindness from glaucoma besides the various complications of diabetic retinopathy.

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Brief reportThe Relationship Between Anterior Chamber Depth and the Presence of Diabetes in the Tanjong Pagar Survey

Purpose

Design

Methods

Results

Conclusions

Am J Ophthalmol

Ophthalmology

Ophthalmology

Brief report
The Relationship Between Anterior Chamber Depth and the Presence of Diabetes in the Tanjong Pagar Survey