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.
- child health (paediatrics)
Data availability statement
Data are available upon reasonable request. Data are available upon reasonable request.
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Contributors All the authors met the criteria of contributorship. Study design: RAM. Data collection: HG, BA-J, SS, INP, AKal, GP, PS, SAK, ME, WA, MAH, AKA and KH. Data preparation and analysis: HG, SM and AKha. Drafting of the manuscript: HG and RAM. Critical revision of the manuscript: All authors.
Funding This publication was made possible by a grant from the Sidra Internal Research Fund (SIRF) and a Biomedical Research Program (BMRP- 5726113101) grant from the Qatar National Research Fund (QNRF).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.