Decreased density of corneal basal epithelium and subbasal corneal nerve bundle changes in patients with diabetic retinopathy.
OBJECTIVE
To define alterations in the density of corneal basal epithelium in relation to diabetic retinopathic severity and the alteration of corneal innervation using confocal microscopy.


METHODS
Prospective case-control study.


METHODS
Forty-two type II diabetic patients stratified into nondiabetic (NDR), nonproliferative diabetic (NPDR), and proliferative diabetic (PDR) retinopathy and 14 age-matched healthy control subjects were studied. Epithelial and stromal cell densities and subbasal nerves were investigated by confocal microscopy.


RESULTS
Corneal basal epithelial cell density (P = .0001), nerve fiber density (NFD) (P < .0001), nerve branch density (NBD) (P = .0003), and tortuosity coefficient (Tc) (P < .0001) were significantly different among the four groups. Basal epithelial density was significantly correlated with NFD (r = 0.43, P = .0009), NBD (r = 0.36, P = .007), and TC (r = -0.58, P < .0001).


CONCLUSIONS
Patients with diabetes show alterations in corneal innervations and basal epithelial cell density in different retinopathic stages. We demonstrate that reduced density in basal epithelial cell is correlated with changes in innervation.
Chang
Pei-Yao
PY
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Carrel
Hyman
H
Huang
Jen-Shang
JS
Wang
I-Jong
IJ
Hou
Yu-Chih
YC
Chen
Wei-Li
WL
Wang
Jiun-Yi
JY
Hu
Fung-Rong
FR
D016022:Case-Control Studies; D002452:Cell Count; D003315:Cornea / Q000294:innervation*; D003319:Corneal Stroma / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications*; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009882:Ophthalmic Nerve / Q000473:pathology*; D011446:Prospective Studies