Study of the sub-basal epithelial nerve plexus in diabetic patients thorough corneal confocal microscopy
Keywords:
corneal confocal microscopy; sub-basal epithelial plexus; diabetic retinopathy., corneal confocal microscopy, sub-basal epithelial plexus, diabetic retinopathyAbstract
Objective: To evaluate the morphological changes of the sub-basal epithelial corneal nerve plexus in eyes of diabetic patients and their relation with the severity of diabetic retinopathy.
Method: A descriptive cross-sectional study was carried out, including 39 eyes from 21 patients diagnosed with type 2 diabetes mellitus. Group 1 included patients without diabetic retinopathy; Group 2, non-proliferative diabetic retinopathy; Group 3, Proliferative diabetic retinopathy; and the Control group, with 38 eyes of 19 healthy subjects. All were submitted to the confocal microscopy examination for the study of corneal diabetic neuropathy by analyzing 4 parameters: number of fibers, beading grading, branching pattern and fiber tortuosity.
Results: The numbers of fibers and beading grading, and the branching pattern decreased significantly in diabetic patients compared to the control group (p < 0.001, p<0.001 and p < 0.001, respectively). The fiber tortuosity was found to be increased in diabetic patients compared to the control group. It was observed that as the diabetic retinopathy progresses there is a decrease in the number of fibers and beading grading.
Conclusions: There are morphological changes of the sub-basal epithelial nerve plexus in the eyes of diabetic patients with respect to healthy subjects. These alterations become more severe as the severity of diabetic retinopathy increases.
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