Longitudinal changes in corneal cell and nerve fiber morphology in young patients with type 1 diabetes with and without diabetic retinopathy: A 2-year follow-up study

Abstract

PURPOSE. We have previously used in vivo corneal confocal microscopy (IVCCM) to demonstrate significant alterations in the corneal epithelial cells, stromal keratocytes, and subbasal nerves in young patients with type 1 diabetes mellitis (T1DM), especially those with diabetic retinopathy (DR). We have evaluated the change in corneal cellular and subbasal nerve morphology over 2 years in young patients with T1DM with or without DR. METHODS. A total of 19 patients with T1DM, without (n ¼ 12) and with (n ¼ 7) DR and 19 age-and sex-matched healthy control subjects underwent quantification of corneal cellular and subbasal nerve plexus morphology by using IVCCM at baseline and after 2 years. RESULTS. There was no significant change in corneal basal epithelial, posterior stromal keratocyte, or endothelial cell densities over 2 years. However, there was a significant reduction in corneal nerve branch (P ¼ 0.03) and total nerve branch density (P ¼ 0.04) in patients without DR and a significant reduction in corneal nerve fibre density (P ¼ 0.004) in those with DR. CONCLUSIONS. IVCCM can detect a progressive loss of corneal nerve fibers in young patients with T1DM and may allow the identification of individuals at risk of neuropathy progression for more active risk factor reduction.