|Year : 1989 | Volume
| Issue : 1 | Page : 10-12
The intraocular pressure and diabetes-A correlative study
VK Arora, VN Prasad
Dept. of Ophthalmology, B.R.D. Medical College, Gorakhpur - 273 013, India
V N Prasad
Dept. of Ophthalmology, B.R.D. Medical College, Gorakhpur - 273 013
Source of Support: None, Conflict of Interest: None
In the present study 60 diabetics were examined for intraocular pressure, scleral rigidity and facility of outflow. The intraocular pressure was found higher than in the general population except in patients with proliferative retinopathy. There was no marked difference in scleral rigidity in diabetics. The facility of outflow was lower in diabetic patients.
|How to cite this article:|
Arora V K, Prasad V N. The intraocular pressure and diabetes-A correlative study. Indian J Ophthalmol 1989;37:10-2
|How to cite this URL:|
Arora V K, Prasad V N. The intraocular pressure and diabetes-A correlative study. Indian J Ophthalmol [serial online] 1989 [cited 2020 Apr 7];37:10-2. Available from: http://www.ijo.in/text.asp?1989/37/1/10/26113
| Introduction|| |
Diabetes mellitus within the last four decades has emerged as a major cause of blindness and visual disability not only in developed countries but also in developing countries.
Diabetes, besides it other ocular manifestations also affects the intraocular pressure. Diabetics are more prone to have primary open angle glaucoma. The presence of glaucoma in diabetic patients seems to offer some protection from the development of proliferative retinopathy. However, it is not yet clearly established as to how diabetes affects intraocular pressure. The present study was undertaken to review the possible relationship between ocular tension and diabetes.
| Material and methods|| |
A total of 120 patients were included in the study. Out of these, 60 (120 eyes) were diabetics and rest were normal non diabetic persons forming a control group. All the patients were thoroughly examined. Besides careful tonometry, estimation of scleral rigidity and estimation of facility of aqueous outflow was done. Simultaneous blood sugar levels were also recorded.
On the basis of ophthalmoscopy, patients were divided as diabetics with retinopathy and diabetics without retinopathy. The patients with retinopathy were further categorised into stage I, II, III (Background retinopathy) and IV (Proliferative retinopathy).
The tonometery was done by a standard certified Schiotz tonometer. The same tonometer was used throughout the study.
ESTIMATION OF OCULAR RIGIDITY : - The coefficient of scleral rigidity was calculated by the table according to modified Firdenwald monogram. In the present study two paired readings -of intraocular pressure were taken at 5.5gm and 10 gm. The value common to both readings in the table was the ocular rigidity for the eye.
Estimation of facility of Aqueous Outflow: - Tonography affords one of the most convenient methods for the estimation of outflow facility. It was performed by placing the Schiotz tonometer on the eye for a period of 4 minutes and recording the progressive indentations of the cornea by the plunger. The outflow facility is calculated as -
The values of these are taken from the pressure and volume tables.
| Observations|| |
The observations of this study are based on the findings in 60 patients with diabetes. Out of the total of 60 cases 46 (76.67%) were of maturity onset diabetes while juvenile onset diabetics constituted only 23.3% (14 cases)
The males out numbered the females
| Discussion|| |
Diabetes mellitus is a very common disease. The incidence of diabetic retinopathy is 43.33%. The mean Intraocular pressure in maturity onset diabetes is 19.26 mm which is higher than the normal mean intraocular pressure reported in the general population i.e. 16.1mm of Hg (Becker - Shaffer). In juvenile diabetics the mean intraocular pressure though lower (17.93mm Hg) than the mean LO.P in maturity onset diabetes, was higher, than normal average mean IOP. Thus the finding clearly indicates the higher mean IOP in diabetics as compared to the non-diabetic population. This fact has already been supported by the various workers. However it is not in agreement with the reports of Palomar (1956) and Armaly and Baloglour (1967) who observed low IOP in diabetics as compared to nondiabetics.
The mean IOP of diabetic eyes without retinopathy was 18.17 mm Hg while eyes with retinopathy was 19.99 mm Hg. The significant finding was the lower intraocular pressure (15.98 mm Hg) in proliferative retinopathy. Cristiansson (1961) also reported low IOP in proliferative retinopathy.
According to Mooney (1963) raised IOP retards the growth of retinopathy by compressing capillaries and venules. He did not find diabetic retinopathy in the eyes having glaucoma. Jain et al (1967) in their analysis of 100 patients concluded that higher IOP has some influence in delaying or preventing the retinopathy. The finding of lower intraocular pressure (15.98 mm) is in agreement with the findings of Cristiansson (1961), Money (1963), Yenoff (1969), Igersheimer (1944) and Tiwari et all (191984).
The scleral rigidity in the majority of cases was within the range of 0.0200 to 0.0250. It is in accordance with the normal scleral rigidity. In the present study it was observed that scleral rigidity increased with the increase in age, in maturity onset as well as juvenile diabetes. Diabetes does not appear to affect it.
The facility of aqueous outflow in normal persons was 0.28 ± 0.05 microlitre/min/mm Hg. In glaucoma it has been reported to be 0.16 ± 0.01 microlitre/min/mm Hg. In the present study the value of outflow facility is 0.26 microlitre.min/ mm Hg in maturity onset and 0.24 microlitre/min/mm Hg in. maturity onset and 0.24 microlitre/min/mm Hg in juvenile onset diabetes. So it can be concluded that the facility of aqueous outflow is low in diabetic patients as compared to the normal population.
There was no significant difference in facility of outflow in diabetics with retinopathy and diabetics without retinopathy. However when we compare non proliferative (Grade I, II, III) with proliferative retinopathy (Grade IV) there is a marked difference. The facility of outflow was lower in non-proliferative retinopathy while it was higher or similar to that of the non diabetic population in proliferative retinopathy.
| References|| |
Amstrong J.R., Daily R.K., Dobsen H.L. and Giard L.J., The incidence of Glaucoma in diabetes mellitus, Am.J. Ophth. 50: 55-63, 1960.
Cristiansson, J., Intraocular pressure in diabetes mellitus , Acta. Ophthalmol 39 :159,1961.
Jain I.S., and Luthra, C.L. : Diabetic retinopathy : Its relationship with intraocular pressure.
Igersheimer, J., Intraocular pressure and its relation to extravasation. Arch. Ophth 32 :50, 1944.
Mooney, A.J., Diabetic retinopathy - a challenge, Brit. J. Ophth. 47 : 513,1963.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]