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Gad H, Al-Jarrah B, Saraswathi S, et al. Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus. Br J Ophthalmol. 2021;doi: 10.1136/bjophthalmol-2021-319057.
Gad, H., Al-Jarrah, B., Saraswathi, S., Mohamed, S., Kalteniece, A., Petropoulos, I. N., Khan, A., Ponirakis, G., Singh, P., Khodor, S. A., Elawad, M., Almasri, W., Hendaus, M. A., Akobeng, A. K., Hussain, K., & Malik, R. A. (2021). Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus. The British journal of ophthalmology, . https://doi.org/10.1136/bjophthalmol-2021-319057
Gad, Hoda, et al. "Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus." The British journal of ophthalmology vol. (2021). doi: https://doi.org/10.1136/bjophthalmol-2021-319057
Gad H, Al-Jarrah B, Saraswathi S, Mohamed S, Kalteniece A, Petropoulos IN, Khan A, Ponirakis G, Singh P, Khodor SA, Elawad M, Almasri W, Hendaus MA, Akobeng AK, Hussain K, Malik RA. Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus. Br J Ophthalmol. 2021 Apr 30; doi: 10.1136/bjophthalmol-2021-319057. Epub 2021 Apr 30. PMID: 33931390.
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Br J Ophthalmol. 2021 Apr 30; doi: 10.1136/bjophthalmol-2021-319057. Epub 2021 Apr 30.

Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus.

The British journal of ophthalmology

Hoda Gad, Bara Al-Jarrah, Saras Saraswathi, Sara Mohamed, Alise Kalteniece, Ioannis N Petropoulos, Adnan Khan, Georgios Ponirakis, Parul Singh, Souhaila Al Khodor, Mamoun Elawad, Wesam Almasri, Mohamed A Hendaus, Anthony K Akobeng, Khalid Hussain, Rayaz A Malik

Affiliations

  1. Department of Medicine, Weill Cornell Medicine, Doha, Qatar.
  2. Gastroenterology, Sidra Medicine, Doha, Qatar.
  3. Cardiovascular Medicine, University of Manchester, Manchester, UK.
  4. Research, Sidra Medicine, Doha, Qatar.
  5. General Pediatrics, Sidra Medicine, Doha, Qatar.
  6. Endocrinology, Sidra Medicine, Doha, Qatar.
  7. Department of Medicine, Weill Cornell Medicine, Doha, Qatar [email protected].

PMID: 33931390 DOI: 10.1136/bjophthalmol-2021-319057

Abstract

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.

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: child health (paediatrics); cornea

Conflict of interest statement

Competing interests: None declared.

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