January - March 2015, Volume 11, Issue 1

Burcea M, Tataru CP, Mihai C, Gheorghe A, Schmitzer S

The Use of Corneal Confocal Microscopy for Early Detection of the Affection of Corneal Nerve Fibers in Patients with Type 2 Diabetes

Acta Endo (Buc) 2015, 11 (1): 55-59
doi: 10.4183/aeb.2015.55

Objective. The extremely negative effects of diabetic neuropathy over the entire human organism make the detection of modifications in early stages very important. Introduction. The purpose of this study is to establish a correlation between early modifications appeared at the level of corneal nerves fibers and the glycemic values of patients with type 2 diabetes. The affection of corneal nerves fibers has been emphasized with the help of corneal confocal microscopy (CCM). Method. A total number of 70 subjects have been evaluated of which 55 suffered from type 2 diabetes (group A) and 15 have been subject to control (group B). The ophthalmologic control also contained a confocal microscopy that has highlighted the decrease of the number of nerves filets of the sub-basal plexus, modifications associated with type 2 diabetes. Results. The density of nerves fibers (12.11± 1.064 n/mm2 compared to 28.33 ± 2.101 n/mm2, P= 0.001); the density of nerves branches (29.94 ± 3.980 n/mm2 compared to 43.75 ± 4.605 n/mm2, P<0.001); the length of nerves fibers (11.77 ± 0.638 mm/mm2 compared to 17.82 ± 0.479 mm/mm2, P=0.002), the total density of nerves fibers (23.25 ± 3.213 n/ mm2 compared to 63.75 ± 8.278 n/mm2, P=0.042) and the area of corneal nerves fibers (0.0044 ± 0.000247 mm2 /mm2 compared to 0.007893 ± 0.00054 mm2 /mm2, P=0.014) have been significantly smaller in patients with diabetes compared to healthy subjects. Conclusions. Being a non invasive technique, corneal confocal microscopy represents a technique that can be easily used in the detection of early modifications of fibers of subbasal corneal nerves stratum, in the case of patients suffering from type 2 diabetes.

Keywords: diabetic neuropathy, corneal confocal microscopy, corneal sub-basal nerves plexus.

Correspondence: Constantin Mihai MD, ALCOR Clinic - Ophthalmology, Bd Unirii Nr 71, Bl G2C, Sector 3, Bucharest, 030829, Romania Phone: 0040744539464, E-mail: constantinmihai3@yahoo.com