Central Corneal Thickness can be Related to Diabetic Peripheral Neuropathy in Children with Type 1 Diabetes

Krzysztof Jeziorny; Michal Fila; Aleksandra Pyziak-Skupien; Magdalena Kolodziej; Arleta Waszczykowska; Ewa Zmyslowska-Polakowska; Agnieszka Szadkowska; Wojciech Mlynarski; Agnieszka Zmyslowska

doi:10.1055/a-0972-0957

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2019; 127(10): 672-676
DOI: 10.1055/a-0972-0957

Article

Central Corneal Thickness can be Related to Diabetic Peripheral Neuropathy in Children with Type 1 Diabetes

Krzysztof Jeziorny

¹Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland

,

Michal Fila

²Clinical Neurophysiology Unit, Department of Neurology, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland

,

Aleksandra Pyziak-Skupien

³Department of Pediatrics, Silesian Medical University in Katowice, Poland

,

Magdalena Kolodziej

⁴Department of Practical Obstetrics, Medical University of Lodz, Poland

,

Arleta Waszczykowska

⁵Department of Ophthalmology and Vision Rehabilitation, Medical University of Lodz, Poland

,

Ewa Zmyslowska-Polakowska

⁶Department of Endodontics, Medical University of Lodz, Poland

,

Agnieszka Szadkowska

¹Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland

,

Wojciech Mlynarski

⁷Department of Pediatrics, Oncology and Haematology, Medical University of Lodz, Poland

,

Agnieszka Zmyslowska

¹Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Poland

› Author Affiliations

Abstract

Aims Diabetic eye disease with its various manifestations as well as diabetic neuropathy may occur in patients with type 1 diabetes (T1D) after several years of diabetes duration. Pachymetry is a promising method evaluating central corneal thickness (CCT) in diabetic patients. The aim of the study was to evaluate the CCT values in children with T1D and its relationship to neurophysiological markers of diabetic neuropathy.

Methods The study groups included 119 T1D children with average 5.3 years of diabetes duration and 38 age-matched controls. CCT index was measured with pachymeter in all subjects and in 19/119 of T1D patients the CCT values were referred to the ENG-EMG-SSR study results.

Results In T1D patients the higher CCT values were observed as compared to healthy controls (p=0.037). Correlations between CCT values and both distal latency of the motor fibers of the median nerve (R=0.51; p=0.044) and conduction velocity of this nerve (R=−0.55; p=0.027) were noted. A conduction velocity of the sensory fibers of sural nerve correlated negatively with CCT index (R=−0.50; p=0.045) in the T1D patients.

Conclusions CCT measurement may be helpful in the referral of the asymptomatic pediatric T1D patients to assess an early stage of diabetic neuropathy.

Key words

type 1 diabetes - CCT - HbA1c - ENG-EMG-SSR

Full Text

References

References
1 Grauslund J. Eye complications and markers of morbidity and mortality in long-term type 1 diabetes. Acta Ophthalmol 2011; 89: 1-19
2 Albers JW, Herman WH, Pop-Busui R. et al. Effect of prior intensive insulin treatment during the Diabetes Control and Complications Trial (DCCT) on peripheral neuropathy in type 1 diabetes during the Epidemiology of Diabetes Interventions and complications (EDIC) study. Diabetes Care 2010; 33: 1090-1096
3 Booya F, Bandarian F, Larijani B, Pajouhi M, Nooraei M, Lotfi J. Potential risk factors for diabetic neuropathy: a case control study. BMC Neurol 2005; 5: 24
4 Misra SL, Braatvedt GD, Patel DV. Impact of diabetes mellitus on the ocular surface: a review. Clin Experiment Ophthalmol 2016; 44: 278-288
5 Bikbova G, Oshitari T, Tawada A, Yamamoto S. Corneal changes in diabetes mellitus. Curr Diabetes Rev 2012; 8: 294-302
6 Petropoulos IN, Alam U, Fadavi H. et al. Corneal nerve loss detected with corneal confocal microscopy is symmetrical and related to the severity of diabetic polyneuropathy. Diabetes Care 2013; 36: 3646-3651
7 Maddaloni E, Sabatino F, Del Toro R. et al. In vivo corneal confocal microscopy as a novel non-invasive tool to investigate cardiac autonomic neuropathy in Type 1 diabetes. Diabet Med 2015; 32: 262-266
8 Lee JSE, Oum BS, Choi HY, Lee JSE, Cho BM. Differences in corneal thickness and corneal endothelium related to duration in Diabetes. Eye 2006; 20: 315-318
9 Urban B, Raczyńska D, Bakunowicz-Łazarczyk A, Raczyńska K, Krętowska M. Evaluation of corneal endothelium in children and adolescents with type 1 diabetes mellitus. Mediators Inflamm 2013; 2013: 1-6
10 Shih CY. Clinical Significance of central corneal thickness in the managementof glaucoma. Arch Ophthalmol 2004; 122: 1270
11 Gordon MO. The ocular hypertension treatment study. Arch Ophthalmol 2002; 120: 714
12 Roszkowska AM, Tringali CG, Colosi P, Squeri CA, Ferreri G. Corneal endothelium evaluation in type i and type ii diabetes mellitus. Ophthalmologica 1999; 213: 258-261
13 Scheler A, Spoerl E, Boehm AG. Effect of diabetes mellitus on corneal biomechanics and measurement of intraocular pressure. Acta Ophthalmol 2012; 90: 447-451
14 Jeziorny K, Niwald A, Moll A. et al. Measurement of corneal thickness, optic nerve sheath diameter and retinal nerve fiber layer as potential new non-invasive methods in assessing a risk of cerebral edema in type 1 diabetes in children. Acta Diabetol 2018; 55: 1295-1301
15 Fujishima H. Improvement of corneal fluorescein staining in post cataract surgery of diabetic patients by an oral aldose reductase inhibitor, ONO-2235. Br J Ophthalmol 2002; 86: 860-863
16 World Health Organization . Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia Consultation, report of a WHO/IDF Geneva. Switzerland: World Health Organisation; 2006
17 Su DHW, Wong TY, Wong W-L. et al. Diabetes, hyperglycemia, and central corneal thickness. Ophthalmology 2008; 115: 964-968.e1
18 Anbar M, Ammar H, Mahmoud RA. Corneal endothelial morphology in children with type 1 diabetes. J Diabetes Res 2016; 2016: 1-8
19 Ozdamar Y, Cankaya B, Ozalp S, Acaroglu G, Karakaya J, Özkan SS. Is there a correlation between diabetes mellitus and central corneal thickness?. J Glaucoma 2010; 19: 613-616
20 Galgauskas S, Laurinavičiūtė G, Norvydaitė D, Stech S, Ašoklis R. Changes in choroidal thickness and corneal parameters in diabetic eyes. Eur J Ophthalmol 2016; 26: 163-167
21 Kumar N, Pop-Busui R, Musch DC. et al. Central corneal thickness increase due to stromal thickening with diabetic peripheral neuropathy severity. Cornea 2018; 37: 1138-1142
22 Hossain P, Sachdev A, Malik RA. Early detection of diabetic peripheral neuropathy with corneal confocal microscopy. Lancet 2005; 366: 1340-1343
23 Ahmed A, Bril V, Orszag A. et al. Detection of diabetic sensorimotor polyneuropathy by corneal confocal microscopy in type 1 diabetes: A concurrent validity study. Diabetes Care 2012; 35: 821-828
24 Pritchard N, Edwards K, Russell AW, Perkins BA, Malik RA, Efron N. Corneal confocal microscopy predicts 4-Year incident peripheral neuropathy in type 1 diabetes. Diabetes Care 2015; 38: 671-675
25 Negre-Salvayre A, Salvayre R, Augé N, Pamplona R, Portero-Otín M. Hyperglycemia and glycation in diabetic complications. Antioxid Redox Signal 2009; 11: 3071-3109
26 Kaji Y, Usui T, Oshika T. et al. Advanced glycation end products in diabetic corneas. Investig Ophthalmol Vis Sci 2000; 41: 362-368
27 Hajas G, Kissova V, Tirpakova A. A 10-yr follow-up study for the detection of peripheral neuropathy in young patients with type 1 diabetes. Pediatr Diabetes 2016; 17: 632-641