Anterior segment optical coherence tomography-based corneal pachymetry as a potential biomarker for diabetic keratopathy: An observational study on diabetic patients in North India

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Objectives: The objective of this study was to evaluate central corneal epithelial thickness (CCET) and central corneal thickness (CCT) using anterior segment optical coherence tomography (AS-OCT) in diabetic patients and assess their relationship with the duration of diabetes, tear breakup time (TBUT), and Schirmer’s test. These findings were compared with a nondiabetic population. Materials and Methods: This cross-sectional, observational study included 75 eyes from diabetic patients and 75 eyes from nondiabetic controls. CCET and CCT were measured using AS-OCT, while TBUT and Schirmer’s test were conducted to assess the dry eye status. The correlation between CCET, TBUT, and the duration of diabetes was analyzed. Results: CCET was significantly thinner in diabetic patients (47.09 ± 7.09 μm) compared to controls (50.19 ± 5.92 μm, P = 0.004), with a strong negative correlation between CCET and diabetes duration (Rs. = −0.81). TBUT was also lower in diabetics ( P = 0.001), indicating a higher prevalence of dry eye. CCT differences between groups were nonsignificant ( P = 0.85). Discussion and Conclusion: Baseline CCET and TBUT should be recorded during the initial evaluation of diabetic patients and monitored at regular intervals. AS-OCT-based CCET measurement could serve as a noninvasive biomarker for early detection of diabetic ocular disease progression, enabling prompt management to prevent advanced corneal complications.