RT Journal Article
SR Electronic
T1 Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP bjophthalmol-2021-319057
DO 10.1136/bjophthalmol-2021-319057
A1 Hoda Gad
A1 Bara Al-Jarrah
A1 Saras Saraswathi
A1 Sara Mohamed
A1 Alise Kalteniece
A1 Ioannis N Petropoulos
A1 Adnan Khan
A1 Georgios Ponirakis
A1 Parul Singh
A1 Souhaila Al Khodor
A1 Mamoun Elawad
A1 Wesam Almasri
A1 Mohamed A Hendaus
A1 Anthony K Akobeng
A1 Khalid Hussain
A1 Rayaz A Malik
YR 2021
UL http://bjo.bmj.com/content/early/2021/04/29/bjophthalmol-2021-319057.abstract
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.