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Alcoholism linked to corneal endothelium deterioration
Patients with alcohol dependence syndrome present with significant corneal endothelial abnormalities, likely due to the high concentration of ethanol in the aqueous humor and the consequences of poor nutrition, according to a study.
The corneas of 161 patients with alcohol dependence syndrome (ADS) were compared with those of an equivalent group of healthy subjects.
Further comparisons were made within the group of ADS patients before and after 1 month of enforced abstinence from alcohol during hospitalization. The stages of fatty liver and their correlation with the status of the corneal endothelium were also assessed.
Significant differences were found between the two groups. Corneas of patients with ADS had increased central corneal thickness (CCT) and decreased cell density (CD). After 1 month of abstinence, both parameters improved significantly. A significant correlation was also found between stage of fatty liver, CCT and CD.
“Our results indicate that there is an insult to corneal endothelium with chronic alcohol use,” the authors stated.
They hypothesized that elevated ethanol concentrations in the aqueous humor may be a primary cause of such alterations. Other factors could be related to poor nutritional status, which is commonly associated with alcohol abuse.
Prolonged hypoglycemia, the authors noted, deprives the aqueous humor of an adequate quantity of glucose, an essential nutrient of corneal endothelium. Lack of vitamins A, C and E may also lead to free-radical injury, with consequent cell apoptosis. Hypoglycemia and hypovitaminosis lead, in turn, to depressed activity of the Na+ /K+ -ATPase pump in the corneal endothelium.
“This study makes us aware that we have to be extremely careful in dealing with the eyes of patients with ADS, especially in intraocular procedures like phacoemulsification,” the authors wrote. – by Michela Cimberle
Disclosure: The authors reported no conflict of interest