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Abstract #17040 Published in IGR 9-1
How might corneal elasticity help us understand diabetes and intraocular pressure?
Krueger RR; Ramos-Esteban JCJournal of Refractive Surgery 2007; 23: 85-88
PURPOSE: To determine how changes in corneal elasticity/stiffness might influence intraocular pressure (IOP) readings in diabetic patients. METHODS: A systematic review of the literature was performed to understand the conflicting relationship between diabetes, elevated IOP, and glaucoma progression. RESULTS: Diabetic patients have been found to have statistically significant higher IOP readings in some population-based studies compared to non-diabetics. Insulin resistance states, hyperglycemia and glycosylated hemoglobin have been correlated with higher IOP (1 mmHg) measurements in diabetic patiente. In the Ocular Hypertension Treatment Study (OHTS), a self reported history of diabetes was found to be protective against the progression of primary open-angle glaucoma. Small differences in IOP measurements in diabetic patients may be due to corneal stiffening, as demonstrated by the protective effect of glucose-mediated collagen cross-linking against the manifestation and keratometric progression of keratoconus. Different collagen cross-linking agents may induce different degrees of corneal stiffening, which can result in differences in measured IOP. CONCLUSIONS: Glucose-mediated corneal stiffening due to collagen cross-linking might be responsible for IOP overestimation in diabetic patients. Corneal stiffening might explain why diabetic eyes lend to have higher IOP readings in large population-based studies and why those with ocular hypertension have a reduced risk for glaucoma progression.
Dr. R.R. Krueger, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA. krueger@ccf.org
Classification:
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
