Dear Editor, Diabetic retinopathy (DR) remains one of the leading causes of preventable visual impairment among patients with type II diabetes mellitus worldwide. Although retinal microvascular alterations are well recognized, the potential association between anterior segment ocular biometric parameters and the severity of nonproliferative DR (NPDR) has not been extensively investigated. Recent research suggests that structural ocular parameters may provide additional insight into the risk and progression of diabetic retinal disease.1,2 We conducted a hospital-based cross-sectional study, including 135 participants attending the ophthalmology outpatient department of a tertiary care center. The participants were divided into three groups: diabetic patients with NPDR (n = 45), diabetic patients without retinopathy (n = 45), and nondiabetic controls (n = 45). NPDR severity was graded using the Early Treatment Diabetic Retinopathy Study classification. Ocular biometric parameters such as axial length (AL) and central corneal thickness (CCT) were measured using standard ophthalmic instruments Figures 1-3. In addition, systemic parameters, including glycated hemoglobin, random blood glucose, lipid profile, blood pressure, and duration of diabetes, were evaluated.Figure 1: CCT and anterior segment parameters measured using cirrus hd 500 OCTFigure 2: Biomedix Echovue A-Scan biometer used for measuring Axial lengthFigure 3: A retinal fundus image with diabetic retinopathy. Source: Adapted from published literature on fundus imaging and diabetic retinopathy.Our findings demonstrated that patients with NPDR had significantly shorter AL compared with diabetics without retinopathy and nondiabetic controls. Furthermore, CCT was found to be higher in NPDR patients, indicating possible corneal structural changes associated with chronic hyperglycemia. Poor glycemic control and longer duration of diabetes were also significantly associated with increased NPDR severity, consistent with previous studies highlighting the importance of systemic metabolic factors in DR progression.3–5 These observations suggest that ocular biometric parameters may serve as useful adjunct markers in identifying patients at higher risk for developing DR. Incorporating routine ocular biometry in diabetic eye screening programs may, therefore, aid in early detection and improved monitoring of NPDR. However, the cross-sectional and single-center design of the study limits causal interpretation and generalizability. Future large-scale longitudinal studies are needed to validate the role of ocular biometric measurements as predictive markers for DR progression. Data availability statement Data will be made available on reasonable request to the corresponding authors. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Soumya et al. (Wed,) studied this question.