Corneal endothelial changes in type 2 diabetes mellitus with reference to stage of diabetic retinopathy

The impact of Type 2 Diabetes Mellitus (T2DM) and diabetic retinopathy (DR) stage on corneal endothelial morphology and central corneal thickness (CCT) remains unclear. In this cross-sectional study conducted at R.L. Jalappa Hospital with 80 participants (40 diabetics and 40 controls), specular microscopy revealed that diabetic patients had significantly lower endothelial cell density, reduced hexagonality and increased coefficient of variation, indicating endothelial dysfunction. Although CCT was slightly thinner in diabetics, the difference was not statistically significant. Moreover, analysis across DR severity (No DR, NPDR and PDR) showed no significant correlation with endothelial parameters, despite a worsening trend with disease progression. Thus, we show that corneal endothelial changes in T2DM may occur independently of DR, underscoring the importance of routine corneal evaluation before intraocular procedures.