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| Author, year | Type of study | Study groups | Technology | Parameters | Results |
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| Shenoy, 2009 [131] | Case-control
Prospective | 110 diabetic patients (110 eyes)
27 T1D
83 T2D
110 controls (110 eyes) | NIDEK® confoscan 2. | ECD, coefficient of variability of cell size of cells showing polymegathism, percentage of hexagonal cells showing pleomorphism. | (i) ECD in eyes was negatively associated with the diabetes status.
(ii) The coefficient of variability in endothelial cells with polymegathism was 12 (8 to 16) more among eyes of diabetic patients than that of controls.
(iii) The corneal endothelial cells with pleomorphism were 9% less in controls compared to the diabetic subjects. |
| Módis, 2010 [132] | Case-control
Prospective | 21 insulin-dependent T1D patients (41 eyes)
30 patients with non-insulin-dependent T2D (59 eyes).
Control group 1 (22 patients, 40 eyes). Age-matched normal subjects with T1D group)
Control group 2 (30 patients, 60 eyes). Age-matched normal subjects with T2D group) | Wide-field contact specular microscope (Tomey EM-1000, Tokyo, Japan) | ECD, mean cell area, CV, CCT, IOP | T1D
(i) ECD decreased in T1D in comparison with controls.
(ii) CCT thicker in T1D in comparison with controls.
HbA1c level was inversely correlated with the ECD and correlated with the mean endothelial cell area.
(iii) Positive correlation between glucose level and ECD, endothelial cell area and CCT.
(iv) Negative correlation between ECD and duration of the disease/insulin therapy.
T2D
(i) No differences were found in the evaluated values compared to controls. No correlations were founded |
| Urban, 2013 [133] | Case-control
Prospective | 123 children and adolescents with T1D (123 eyes)
124 controls (124 eyes) | Topcon SP-2000P endothelial microscope. | ECD and CCT | (i) ECD was lower in children-adolescent T1D compared to controls.
(ii) CCT was higher in children-adolescent T1D compared to controls.
(iii) There was no correlation between ECD and metabolic control, HbA1c level and plasma creatinine level.
(iv) Correlation between ECD, CCT, and duration of diabetes was statistically significant. |
| Storr-Paulsen, 2014 [134] | Case-control
Prospective | 107 T2D
128 controls | SP 2000P; Topcon, Tokyo, Japan. | ECD, CV, hexagonality percentage and CCT | (i) No differences between groups.
(ii) Higher HbA1c was associated with lower ECD.
(iii) CCT increased in the T2D group. |
| Leelawongtawun, 2015 [135] | Case-control
Prospective | 90 diabetic patients (171 eyes)
(i) 1 patient (two eyes) with severe NP-DR.
(ii) 7 patients (11 eyes) with moderate NP-DR
(iii) 13 patients (24 eyes) with mild NP-DR
(iv) 71 patients (134 eyes) with no DR
90 controls (156 eyes). | Specular microscope (Confoscan4, Nidek) | ECD, percentage of polymegathism, and hexagonality percentage. | (i) No differences between diabetes and controls
(ii) The over one year diabetic patients had a decreased percentage of hexagonal cell compared to controls.
(iii) The over two years diabetic patients had a decreased percentage of hexagonal cell and an increased percentage of polymegathism compared to controls. |
| Calvo-maroto, 2015 [13] | Retrospective | 77 noninsulin T2D (77 eyes):
(i) Short-term diabetic subjects (recently diagnosed,<1 year since diagnosis)
(ii) Long-term diabetic subjects (diagnosed and treated for 10 years or more) s80 controls (80 eyes) | Topcon SP-3000P noncontact specular microscope | CCT, ECD | (i) CCT higher in long-term diabetic patients when compared with short-term diabetic patients and controls.
(ii) ECD lower in long-term diabetic patients when compared with short-term diabetic patients and controls. |
| Szalai, 2016 [12] | Case-control
Prospective | 28 T1D (28 eyes)
18 with DR
10 without DR
17 age-matched controls (17 eyes) | Corneal confocal microscopy with Heidelberg Retina Tomograph III Rostock Cornea Module (HRT III RCM, Heidelberg Engineering GmbH, Heidelberg, Germany) | ECD Other (epithelial, stromal density. Subbasal nerve morphology) | ECD was lower in T1D with and without DR compared to controls. |
| Anbar, 2016 [136] | Case-control
Prospective | 80 T1D children (160 eyes)
40 controls (80 eyes) | Noncontact specular microscope (Topcon SP-1P, Tokyo, Japan). | CCT, ECD, polymegathism, and pleomorphism | (i) CCT higher in the T1D group.
(ii) ECD lower in the T1D group.
(iii) Percentage of hexagonality lower in the T1D group. Polymegathism higher in the T1D group.
(iv) All changes are correlated only with the duration of diabetes |
| Leelawongtawun, 2016 [137] | Case-control
Prospective | 148 diabetes (271 eyes). Divided based on diabetes duration
(i) Below 5 years
(ii) 5 to 10 years
(iii) Over 10 years
(iv) 46 controls (82 eyes) | Specular microscope (Confoscan4 (CS4), Nidek) | ECD, percentage of polymegathism and hexagonality percentage | (i) ECD was lower in all diabetes groups compared to controls.
(ii) In all groups of diabetes, the polymegathism percentage was more than while the hexagonality percentage was less than controls.
(iii) There were no differences in all endothelial parameters between 3 groups of diabetes. |
| Galgauskas, 2016 [77] | Case-control
Prospective | 62 T2D (123 eyes):
(i) 22 (17.9%) eyes with DR
(ii) 10 (8.1%) eyes with macular edema
65 controls (120 eyes) | Noncontact specular microscope (SP-9000; Konan Medical Inc., Hyogo, Japan) | CCT, ECD, average size, hexagonality percentage and polymegathism | (i) ECD lower in diabetes than in controls.
(ii) CCT higher in diabetes than in controls.
(iii) Hemoglobin A1C and the duration of diabetes not associated with any of the examined parameters |
| El-agamy, 2017 [79] | Case-control
Prospective | 57 T2D (57 eyes): 36 eyes without DR
14 eyes with NP-DR
7 eyes with P-DR.
45 controls (45 eyes) | EM-3000 Specular Microscope | CCT, ECD, CV and hexagonality percentage | (i) ECD lower in diabetes than in controls.
(ii) CV higher in diabetes. |
| Islam, 2017 [138] | Case-control
Prospective | 149 diabetes (149 eyes)
(i) 52 T1D
(ii) I97 T2D
149 controls(149 eyes) | SP–3000P, Topcon Corporation, Japan | ECD, average cell size, CV and hexagonality percentage | (i) ECD lower in the diabetes group
Diabetes longer than 10 years had significantly lower ECD and larger average size.
(ii) Diabetes duration was correlated with ECD, polymegethism and hexagonality |
| Qu, 2017 [13] | Case-control
Prospective | 87 T2D (87 eyes): (i) 48 eyes without cornea fluorescein staining
(ii) 39 eyes with cornea fluorescein staining
51 controls (51 eyes) | Keratograph 5M (K5M; OCULUS Optikgerate GmbH, Wetzlar, Germany) | Basal epithelial cell density, subbasal nerve plexus density, langerhans cell density and ECD. | No differences in ECD between groups |
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