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Dry Eye in Children and Adolescents With Type 1 Diabetes Is Closely Associated With Corneal Nerve Morphological
Xi Qu1, Qiurong Lin2, Lei Zhong1
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Insights
Children and adolescents with type 1 diabetes and dry eye show significantly reduced corneal nerve density and length. This indicates a strong link between corneal nerve damage and diabetic dry eye in younger populations.
Area of Science:
- Ophthalmology
- Diabetology
- Neuroscience
Background:
- Type 1 diabetes (T1D) can affect ocular health, including the corneal nerves.
- Diabetic dry eye is a common complication in patients with T1D.
- Understanding corneal nerve changes in pediatric T1D is crucial for early detection and management.
Purpose of the Study:
- To compare corneal nerve morphology in children and adolescents with T1D, differentiating between those with and without dry eye.
- To investigate the association between corneal nerve damage and the presence of diabetic dry eye.
Main Methods:
- Cross-sectional study involving 50 pediatric patients with T1D at an eye hospital.
- Corneal nerve morphology assessed via in vivo confocal microscopy (nerve fiber density, branch density, fiber length, total branch density).
- Corneal nerve index derived using principal component analysis; logistic regression and correlation analyses performed.
Main Results:
- Patients with diabetic dry eye exhibited significantly lower corneal nerve fiber density, branch density, fiber length, and total branch density compared to those without dry eye.
- The corneal nerve index was found to be significantly associated with diabetic dry eye.
- No significant demographic differences were noted between the dry eye and non-dry eye groups.
Conclusions:
- Children and adolescents with T1D and dry eye demonstrate more pronounced corneal nerve damage.
- Corneal nerve impairment is potentially linked to the development of dry eye in this pediatric population.
- Findings highlight the importance of monitoring corneal nerve health in young T1D patients with dry eye symptoms.
Background:
To compare corneal nerve morphology between children and adolescents with type 1 diabetes who have dry eye and those without dry eye, and to investigate the association between corneal nerve damage and diabetic dry eye.
Methods:
This cross-sectional study was conducted at an eye hospital. Fifty paediatric patients with type 1 diabetes were divided into dry eye and non-dry eye groups. Corneal nerve morphology was assessed using in vivo confocal microscopy, including corneal nerve fibre density, corneal nerve branch density, corneal nerve fibre length, and corneal total branch density. Principal component analysis derived the corneal nerve index. Logistic regression and correlation analysis were conducted to evaluate the association between corneal nerve index and diabetic dry eye.
Results:
There were no significant differences in age, gender, and other demographic characteristics between the two groups. Compared with participants without dry eye, those with dry eye showed significantly lower corneal nerve fibre density (19.93 ± 5.25 vs. 24.70 ± 6.77/mm2, p = 0.007), corneal nerve branch density (24.45 ± 13.86 vs. 34.38 ± 12.48/mm2, p = 0.011), corneal nerve fibre length (13.62 ± 2.03 vs. 15.04 ± 2.41 mm/mm2, p = 0.029), and corneal total branch density (39.95 ± 17.02 vs. 51.19 ± 19.01/mm2, p = 0.032). The corneal nerve index was significantly associated with diabetic dry eye.
Conclusions:
Children and adolescents with type 1 diabetes and dry eye exhibit more severe corneal nerve damage, suggesting a potential association between corneal nerve impairment and dry eye in this population.
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