Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus. Issue 10 (30th April 2021)

• Record Type: Journal Article
• Authors: Gad, Hoda; Al-Jarrah, Bara; Saraswathi, Saras; Mohamed, Sara; Kalteniece, Alise; Petropoulos, Ioannis N; Khan, Adnan; Ponirakis, Georgios; Singh, Parul; Khodor, Souhaila Al; Elawad, Mamoun; Almasri, Wesam; Hendaus, Mohamed A; Akobeng, Anthony K; Hussain, Khalid; Malik, Rayaz A
• Is Part Of: British journal of ophthalmology. Volume 106:Issue 10(2022)
• Page Start: 1368
• Page End: 1372
• Publication Date: 2021-04-30
• Subjects: cornea -- child health (paediatrics); Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2021-319057
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Purpose: To assess whether alterations in stromal keratocyte density are related to loss of corneal nerve fibres in children with type 1 diabetes mellitus (T1DM). Methods: Twenty participants with T1DM and 20 age-matched healthy controls underwent corneal confocal microscopy. Corneal sub-basal nerve morphology and corneal keratocyte density (KD) were quantified. Results: Corneal nerve fibre density (CNFD) (p<0.001), corneal nerve branch density (p<0.001), corneal nerve fibre length (CNFL) (p<0.001) and inferior whorl length (IWL) (p<0.001) were lower in children with T1DM compared with healthy controls. Anterior (p<0.03) and mid (p=0.03) stromal KDs were lower with no difference in posterior KD (PKD) in children with T1DM compared with controls. Age, duration of diabetes, height, weight and body mass index did not correlate with anterior (AKD), mid (MKD) or PKD. Inverse correlations were found between glycated haemoglobin and PKD (r=−0.539, p=0.026), bilirubin with MKD (r=−0.540, p=0.025) and PKD (r=−0.531, p=0.028) and 25-hydroxycholecalciferol with MKD (r=−0.583, p=0.018). CNFD, CNFL and IWL did not correlate with AKD, MKD or PKD. Conclusion: This study demonstrates a reduction in corneal nerves and anterior and mid stromal KD in children with T1DM, but no correlation between corneal nerve and keratocyte cell loss.