Open AccessCorneal nerve loss in children with type 1 diabetes mellitus without retinopathy or microalbuminuria
Author(s) -
Gad Hoda,
AlJarrah Bara,
Saraswathi Saras,
Petropoulos Ioannis N,
Ponirakis Georgios,
Khan Adnan,
Singh Parul,
Al Khodor Souhaila,
Elawad Mamoun,
Almasri Wesam,
Abdelrahman Hatim,
Elawwa Ahmed,
Khalifa Amel,
Shamekh Ahmed,
AlKhalaf Fawziya,
Petrovski Goran,
Al Zyoud Mahmoud,
Al Maadheed Maryam,
Hendaus Mohamed A,
Hussain Khalid,
Akobeng Anthony K,
Malik Rayaz A
Publication year - 2020
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13313
Subject(s) - medicine , ophthalmology , nerve fiber , glycated hemoglobin , diabetes mellitus , confocal microscopy , microalbuminuria , nerve fiber layer , optic nerve , anatomy , type 2 diabetes , endocrinology , biology , microbiology and biotechnology
Aims/Introduction Corneal confocal microscopy is a rapid, non‐invasive ophthalmic technique to identify subclinical neuropathy. The aim of this study was to quantify corneal nerve morphology in children with type 1 diabetes mellitus compared with age‐matched healthy controls using corneal confocal microscopy. Materials and Methods A total of 20 participants with type 1 diabetes mellitus (age 14 ± 2 years, diabetes duration 4.08 ± 2.91 years, glycated hemoglobin 9.3 ± 2.1%) without retinopathy or microalbuminuria and 20 healthy controls were recruited from outpatient clinics. Corneal confocal microscopy was undertaken, and corneal nerve fiber density ( n /mm 2 ), corneal nerve branch density ( n /mm 2 ), corneal nerve fiber length (mm/mm 2 ), corneal nerve fiber tortuosity and inferior whorl length (mm/mm 2 ) were quantified manually. Results Corneal nerve fiber density (22.73 ± 8.84 vs 32.92 ± 8.59; P < 0.001), corneal nerve branch density (26.19 ± 14.64 vs 47.34 ± 20.01; P < 0.001), corneal nerve fiber length (13.26 ± 4.06 vs 19.52 ± 4.54; P < 0.001) and inferior whorl length (15.50 ± 5.48 vs 23.42 ± 3.94; P < 0.0001) were significantly lower, whereas corneal nerve fiber tortuosity (14.88 ± 5.28 vs 13.52 ± 3.01; P = 0.323) did not differ between children with type 1 diabetes mellitus and controls. Glycated hemoglobin correlated with corneal nerve fiber tortuosity ( P < 0.006) and aspartate aminotransferase correlated with corneal nerve fiber density ( P = 0.039), corneal nerve branch density ( P = 0.003) and corneal nerve fiber length ( P = 0.037). Conclusion Corneal confocal microscopy identifies significant subclinical corneal nerve loss, especially in the inferior whorl of children with type 1 diabetes mellitus without retinopathy or microalbuminuria.