Subbasal Corneal Plexus Involvement in Different Stages of Diabetic Retinopathy

Abstract

 

Purpose:

 

to investigate subbasal corneal plexus involvement with the Cornea Module of HRT II in patients with diabetic retinopathy.

 

Methods:

 

20 consecutive diabetic patients (age: 67±11 years, range 38-85 years, F/M=12/8) underwent fluorescein angiography with HRA (Heidelberg Retinal Angiograph) and Confoscan corneal tomography with HRT II (Heidelberg Retinal Tomograph) in the same session. Diabetic retinopathy was staged based on ETDRS criteria and the density and the morphological changes (reduction of reflectivity, increase of tortuosity) of the subbasal corneal plexus were staged according to the criteria proposed by Oliveira-Soto. The corneal gradings for nerve density, reflectivity and tortuosity were also summarized in a global parameter.Retinal and corneal staging were compared using chi-square test and their correlation was studied by means of Pearson’s coefficient of correlation.

 

Results:

 

based on ETDRS classification, 6 patients had mild, 7 moderate, 1 severe non proliferative and 6 proliferative diabetic retinopathy. Corneal classification is summarized in the Table.All the corneal patterns worsened with the worsening of retinopathy, and the correlation between retinal and corneal patterns was good (diabetic retinopathy v corneal nerve density, R2=0.63; v nerve tortuosity, R2=0.55; v nerve reflectivity, R2=0.69; P=0.0008, 0.0258, 0.0008 respectively). A strong correlation (R2=0.80) was also found when considering diabetic retinopathy and whole corneal changes.

 

Conclusions:

 

the results of the present study suggest that worsening of diabetic retinopathy is paralleled by changes of subbasal corneal plexus examined with the corneal module of HRT II.  

 

Keywords: cornea: clinical science • diabetic retinopathy