ASSESSING CORNEAL ALTERATIONS IN ENDOCRINE DISORDERS: A CROSS SECTIONAL OBSERVATIONAL CLINICAL STUDY

• JETLINE WRITERS*

Abstract

AIM: Clinical assessment of corneal alterations in endocrine disorders. INTRODUCTION: Corneal alterations are frequent in many endocrine disorders like Graves Ophthalmopathy and Diabetes mellitus. It is a challenge to an ophthalmologist for early detection of such change as it can prevent visual impairment. MATERIAL AND METHOD: A prospective observational hospital-based study conducted over a period of 2 years including 150 patients of different endocrine disorders. In each patient meticulous history taking, complete ophthalmological tests including slit lamp biomicroscopy, ocular surface staining, TBUT, schirmer’s test I, CCT measured by pachymetry, endothelial parameters like ECD, CV, HEX measured by clinical specular microscope. RESULT: The study revealed an age range of 14 to 82 years with a mean age of 48.43±14.2 years, and a male to female ratio of 1.34:1. Prevalent endocrine disorders included Type 2 DM (64.7%), Grave’s Ophthalmopathy (12%), Hypothyroidism (13.3%), Type-1 DM (4.7%), Hyperparathyroidism (2%), Cushing’s syndrome (2.7%), and Addison’s disease (0.7%). Epithelial abnormalities like SPK were found in 28.57% in DM1, 19.59% in DM2, and 25% in hypothyroidism. Corneal ulcers were present in 4.1% of DM2 patients and 11.1% of GO patients. Exposure keratopathy (44.4%) and SLKC (11.1%) were exclusive to GO. Diminished corneal sensation was observed in 28.6% of DM1, 26.8% of DM2, and 22.4% of GO cases. Dry eye was prevalent in 14.3% of DM1, 32% of DM2, 55.6% of GO, and 35% of hypothyroid patients. Changes in central corneal thickness (CCT) and endothelial cell density (ECD) were significant in both DM1 and DM2 groups, with increased CCT and decreased ECD. Additionally, coefficient of variation (CV) was elevated in both DM1 and DM2, while endothelial hexagonality (HEX) was decreased significantly in both groups. CONCLUSION: The present study showed that different corneal alterations can be possible in endocrine disorders. So all endocrine disorders should undergo comprehensive ophthalmological examination to prevent visual impairment.

Keywords

corneal alterations, DM, GO, Hypothyroidism