title: Effect of panretinal photocoagulation on corneal sensation and the corneal subbasal nerve plexus in diabetes mellitus.
abstract: OBJECTIVE
  To assess the effects of panretinal photocoagulation (PRP) for diabetic retinopathy (DR) on the human corneal subbasal nerve plexus (SBNP) and to investigate correlations between corneal subbasal nerve (SBN) density, corneal sensitivity, and diabetic peripheral neuropathy.
  
  
  METHODS
  Thirty-eight subjects with at least a 10-year history of diabetes mellitus (DM) or DR were included. Subjects were assigned to a PRP group (n = 19), having undergone a treatment of retinopathy in at least one eye or a non-PRP group (n = 19), with no history of PRP. The Michigan Neuropathy Screening Instrument (MNSI) was administered to enable quantification of neuropathic symptoms. Laser scanning in vivo confocal microscopy was performed to capture images of the corneal SBNP to allow determination of SBNP density. Central corneal sensitivity (CST) was evaluated by noncontact aesthesiometry and peripheral vibration perception threshold was measured with a biothesiometer.
  
  
  RESULTS
  Mean SBNP densities were 12.27 ± 4.28 mm/mm²) in the PRP group and 12.75 ± 3.59 mm/mm² in the non-PRP group. There were no significant differences in SBNP density (P = 0.71), CST (P = 0.84), MNSI score (P = 0.19), and biothesiometry (P = 0.77) between the PRP and non-PRP groups. When data from both groups (n = 38) were combined, corneal sensitivity was modestly correlated with SBNP density (r = 0.30, P = 0.06), and peripheral biothesiometry (r = 0.26, P = 0.11).
  
  
  CONCLUSIONS
  In DM correlation of corneal sensitivity, SBNP density, and peripheral biothesiometry may have a potential role in estimating the severity of peripheral neuropathy. Corneal SBNP density and sensitivity appear to be unaffected by PRP laser treatment compared with non-PRP diabetic eyes.
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Stuti
authors.initials: S
authors.lastname: Misra
authors.forename: Ha Na
authors.initials: HN
authors.lastname: Ahn
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Craig
authors.forename: Monika
authors.initials: M
authors.lastname: Pradhan
authors.forename: Dipika V
authors.initials: DV
authors.lastname: Patel
authors.forename: Charles N J
authors.initials: CN
authors.lastname: McGhee
mesh_terms: D000368:Aged; D003315:Cornea / Q000294:innervation / Q000528:radiation effects*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008028:Light Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000528:radiation effects*; D012684:Sensory Thresholds / Q000502:physiology
keywords: cornea; diabetes; in vivo confocal microscopy; panretinal photocoagulation; subbasal nerves