PT  - JOURNAL ARTICLE
AU  - Hoda Gad
AU  - Bara Al-Jarrah
AU  - Saras Saraswathi
AU  - Sara Mohamed
AU  - Alise Kalteniece
AU  - Ioannis N Petropoulos
AU  - Adnan Khan
AU  - Georgios Ponirakis
AU  - Parul Singh
AU  - Souhaila Al Khodor
AU  - Mamoun Elawad
AU  - Wesam Almasri
AU  - Mohamed A Hendaus
AU  - Anthony K Akobeng
AU  - Khalid Hussain
AU  - Rayaz A Malik
TI  - Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus
AID  - 10.1136/bjophthalmol-2021-319057
DP  - 2021 Apr 30
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2021-319057
4099  - http://bjo.bmj.com/content/early/2021/04/29/bjophthalmol-2021-319057.short
4100  - http://bjo.bmj.com/content/early/2021/04/29/bjophthalmol-2021-319057.full
AB  - 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.Data are available upon reasonable request. Data are available upon reasonable request.