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Alise Kalteniece, Maryam Ferdousi, Shazli Azmi, Andrew Marshall, Handrean Soran, Rayaz A. Malik; Keratocyte Density Is Reduced and Related to Corneal Nerve Damage in Diabetic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2018;59(8):3584-3590. doi: 10.1167/iovs.18-23889.
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The purpose of this study was to assess the relationship between corneal keratocyte density (KD) and corneal nerve damage in patients with and without diabetic peripheral neuropathy.
Eighty-six patients with type 1 and type 2 diabetes and 21 age-matched control subjects underwent assessment of the neuropathy disability score, quantitative sensory testing, electrophysiology, and corneal confocal microscopy and were divided into those without (DN−) (n = 22) and with (DN+) (n = 64) diabetic neuropathy. Corneal sub-basal nerve parameters and KD in the anterior, mid, and posterior stroma were quantified.
Anterior, mid, and posterior stromal KD were significantly reduced in DN− (P = 0.02, P = 0.009, P = 0.01, respectively) and DN+ (all P < 0.0001) subjects compared to controls. Corneal nerve branch density (CNBD) (P < 0.0001, P < 0.0001) and corneal nerve fiber length (CNFL) (P = 0.03, P < 0.0001) were significantly reduced in DN− and DN+ subjects, respectively, and corneal nerve fiber density (CNFD) (P < 0.0001) was significantly reduced only in DN+ subjects compared to controls. Anterior, mid, and posterior stromal KD correlated significantly with CNFD (P = 0.008, P = 0.005, P = 0.01), CNBD (P = 0.01, P = 0.006, P = 0.001), and CNFL (P = 0.04, P = 0.008, P = 0.003), respectively.
This study demonstrates a reduction in anterior, mid, and posterior KD, which is associated with corneal sub-basal plexus nerve damage in patients with diabetes.
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