June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
In vivo corneal confocal microscopy detects progressive loss of epithelial cells and sub-basal nerve fibers over 2 years in young patients with type 1 diabetes
Author Affiliations & Notes
  • Eszter Anikó Deák
    Department of Biochemistry and Molecular Biology, University of Debrecen, Debrecen, Hungary
    Department of Ophthalmology, University of Debrecen, Debrecen, Hungary
  • Eszter Szalai
    Department of Ophthalmology, University of Debrecen, Debrecen, Hungary
  • Noémi Tóth
    Department of Ophthalmology, University of Debrecen, Debrecen, Hungary
  • András Berta
    Department of Ophthalmology, University of Debrecen, Debrecen, Hungary
  • Rayaz A Malik
    Weill Cornell Medicine and Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
  • Adrienne Csutak
    Department of Ophthalmology, University of Debrecen, Debrecen, Hungary
  • Footnotes
    Commercial Relationships   Eszter Deák, None; Eszter Szalai, None; Noémi Tóth, None; András Berta, None; Rayaz Malik, None; Adrienne Csutak, None
  • Footnotes
    Support  HARVO Travel Grant
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1017. doi:
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      Eszter Anikó Deák, Eszter Szalai, Noémi Tóth, András Berta, Rayaz A Malik, Adrienne Csutak; In vivo corneal confocal microscopy detects progressive loss of epithelial cells and sub-basal nerve fibers over 2 years in young patients with type 1 diabetes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1017.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The aim of this study was to quantify abnormalities in corneal epithelial, stromal and endothelial cell density and sub-basal nerve fiber morphology over 2 years in young patients with type 1 diabetes mellitus (T1DM) with (DR) and without diabetic retinopathy using in vivo corneal confocal microscopy (CCM).

Methods : 19 young T1DM patients (12 male and 8 female; mean age: 20.03±13.5 years) with DR (n=7) and without DR (n=12) and 19 age and sex-matched healthy control subjects (10 male and 8 female; mean age: 22.56±13.7 years) underwent in vivo CCM examination at baseline and at 2 years follow-up. Corneal nerve fiber density (CNFD), length (CNFL), area (CNFA), width (CNFW), branch density (CNBD) and total branch density (CTBD) were analyzed using automated software (ACCMetrics) epithelial, keratocyte and endothelial cell densities were analyzed using semi-automated software by the same skilled examiner.

Results : There was a significant reduction in epithelial cell density (p=0.05) with a significant increase in keratocyte cell density (p=0.002) and no change in endothelial cell density over 2 years. CNFD (p=0.002) and CNFL (p=0.006) showed a significant reduction, especially in T1DM patients without retinopathy. There was a non-significant increase in HbA1c (without DR (68.25±17.07 vs 71.16±15.07 mmol/mol, with DR (72.80±20.24 vs 75.84±4.97 mmol/mol)) and cholesterol (without DR 4.32±0.58 vs 4.58±0.89 mmol/L, with DR (4.88±0.57 vs 5.4±0.33 mmol/L)) over 2 years. Triglyceride levels, HDL, eGFR and blood pressure did not show any change.

Conclusions : Our finding suggests that in vivo CCM can detect progressive corneal epithelial, stromal and nerve fiber loss over a relatively short period in young patients with T1DM. This study support the role of in vivo CCM in following up patients with diabetes mellitus as a part of routine ophthalmological examination.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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