Ultrastructure of Iris Muscles in Diabetes mellitus

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Abstract
The fine structure of iris muscles from 16 iris specimens in patients with diabetes mellitus was investigated by EM and the results were compared with those of 10 specimens of senile cataract eye without diabetes of corresponding age groups. Significant ultrastructural changes were found at the regions of the dilator and sphincter muscles and of the nerve endings adjacent to them. The cytoplasm of the muscle cells was partly occupied by membraneous structures with concentric lamellar appearance. Cytoplasmic vacuolations were noted in the muscle cells. An increased number of lipid droplets associated with pigment granules in the cells was found in all diabetic iris specimens. These 3 kinds of pathological changes (lamellar structure, vacuole and lipid droplet) increased depending on the duration and the control of the disease. Although these findings were noted both in the sphincter and dilator muscles, the latter seemed to be more severely affected. Degenerative nerve endings containing lamellar membraneous structures were observed in a few moderate cases. Nerve fibers frequently diminished in diabetic patients, especially in severe cases of longer duration and poorly controlled cases. Diabetes apparently involves the iris muscle cells and the nerves, and these changes might produce a pupillary abnormality.

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