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Corneal Sensitivity Is Linked to Diabetic Neuropathy

Posted: Friday, August 03, 2007

Results of a new study suggest that corneal sensitivity is reduced in diabetic patients, and is related to the severity of neuropathy.

"In diabetic patients, corneal sensitivity is reduced, due to a loss of corneal nerve fibers, which leads to corneal keratopathy and a susceptibility to injury, with recurrent erosions and ulcers," Dr. Rayaz A. Malik, of the University of Manchester, UK, and colleagues write. Corneal sensation, they add, can be evaluated using the Cochet-Bonnet aesthesiometer (C-BA) or the noncontact corneal aesthesiometer (NCCA).

The researchers examined corneal sensitivity in 147 diabetic patients and 18 controls using these approaches and also assessed neuropathy deficit score. Neuropathy was classified as being absent, mild, moderate or severe.

No significant differences in age, type of diabetes, and A1C were observed among the groups. The duration of diabetes increased with neuropathic severity. Corneal sensitivity assessed using the CB-A was significantly reduced in patients with diabetes compared with controls. It was not reduced in diabetic patients without neuropathy. However, a significant reduction was observed in those with any degree of neuropathy.

A significant reduction in corneal sensitivity assessed using NCCA was seen in the diabetic patients. It was not significantly reduced in patients without neuropathy or with mild neuropathy. However, a significant reduction was found in subjects with moderate and severe neuropathy. A significant correlation was observed between neuropathy established by C-BA and NCCA.

The findings, the investigators conclude "have important clinical implications regarding the development of corneal abnormalities in diabetic patients and also raise the possibility that corneal sensation could be used to screen for diabetic neuropathy."

Source: Diabetes In Control: Diabetes Care 2007;30:1895-1897