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.
- Corneal confocal microscopy
- Type 1 diabetes mellitus
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience