Reduced corneal nerve fibre length in prediabetes and type 2 diabetes: The Maastricht Study.

Abstract

PURPOSE:

In individuals with diabetes, injury to the corneal nerve fibres predisposes to delayed corneal epithelial healing, reduced corneal sensitivity and corneal erosion. We investigated to what extent a reduction in corneal nerve fibre length (CNFL) is present in individuals with prediabetes or type 2 diabetes (DM2) compared with individuals with normal glucose metabolism (NGM).

METHODS:

Using composite images acquired by corneal confocal microscopy, we assessed total CNFL per mm2 in the subbasal nerve plexus of the cornea in 134 participants (mean age 59 ± 8 years, 49% men, 87 NGM, 20 prediabetes, 27 DM2). Multivariable linear regression was used to assess the association between CNFL and glucose metabolism status, adjusted for age and sex.

RESULTS:

In individuals with type 2 diabetes, the mean CNFL was significantly reduced [β = -1.86 mm/mm2 (95% CI -3.64 to -0.08), p = 0.04], as compared with individuals with normal glucose metabolism after adjustment for age and sex. Part of the reduction was present in individuals with prediabetes [β = -0.96 mm/mm2 (95% CI -2.91 to 0.99), p = 0.34], with a linear trend of corneal nerve fibre reduction with severity of glucose metabolism status (p trend = 0.04).

CONCLUSIONS:

A significant reduction in CNFL was found in individuals with DM2 compared with individuals with NGM. A trend of reduction in CNFL was observed between individuals with NGM and prediabetes. The reduction in corneal nerve fibre length could contribute to a delayed corneal healing and an increased risk for corneal complications after surgery.

• Authors: Eline E B De Clerck, Jan S A G Schouten, Tos T J M Berendschot, Renée S Koolschijn, Rudy M M A Nuijts, Miranda T Schram, Nicolaas C Schaper, Ronald M A Henry, Pieter C Dagnelie, Alfredo Ruggeri, Pedro Guimarães, Coen D A Stehouwer, Carroll A B Webers
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 98 Issue 5 Pg. 485-491 (Aug 2020) ISSN: 1755-3768 [Electronic] England
• PMID: 32017403 (Publication Type: Journal Article)
• Copyright: © 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.