Corneal Sub-basal Nerve Plexus Architecture In Patients With Diabetes Mellitus

1. Stuti Misra¹
2. Jennifer P Craig
3. Charles NJ McGhee
4. Dipika V Patel

¹Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand

Purpose: To evaluate the two-dimensional plexus architecture of the corneal sub-basal nerve plexus of participants with type 1 diabetes mellitus, using in vivo confocal microscopy (IVCM).

Methods: Two male subjects, aged 39 and 40 years, with type 1 diabetes mellitus were recruited. Laser scanning IVCM was performed on the right eyes of both subjects. A contiguous montage of IVCM images was prepared using Adobe / Macromedia Freehand 10 (Macromedia Inc, USA). The sub-basal nerve density was evaluated using analySIS 3.1 software.

Results: In both subjects, the sub-basal nerve plexus exhibited a clockwise whorl configuration inferior to the central cornea. Sub-basal nerve density at the whorl was 24.64 mm/mm² and 20.05 mm/mm² in the subjects, respectively. The nerve density at the central cornea was 7.44 mm/mm² and 7.02 mm/mm².

Conclusion: The clockwise whorl pattern of sub-basal corneal nerves observed in this study was similar to that in normal eyes. The nerve densities in the whorl region and the central cornea were reduced relative to normal, similar to animal studies. This is the first study to describe the corneal sub-basal nerve plexus architecture in patients with diabetes mellitus.