Diabetes can result in numerous ocular issues. As such, a new study by a team of Australian researchers found corneal nerve loss in diabetic patients may be tied to a decline in their kidney function as well. Their investigation, published in The Ocular Surface, also suggests corneal confocal microscopy may be a helpful tool in detecting decreased corneal density in these patients.

The study examined the changes in corneal nerve morphology as a result of peripheral neuropathy due to renal dysfunction in people with type 2 diabetes.

The investigators enrolled 62 participants who were approximately 62 years old with type 2 diabetes and 25 age-matched healthy controls. Based on their creatinine blood levels, participants were classified into those with diabetic chronic kidney disease and those without chronic kidney disease. All patients underwent a comprehensive neuropathy assessment and corneal confocal microscopy imaging. The researchers measured the participants’ corneal nerve fiber length, fiber density, branch density, total branch density, nerve fractal dimension, inferior whorl length and inferior whorl nerve fractal dimension.

The study found the patients with chronic kidney disease had significantly lower corneal nerve fiber density, length and nerve fractal dimension compared with the controls. The researchers also observed an association of reduced corneal nerve fiber density, length and nerve fractal dimension with low creatinine blood levels when adjusted for age, duration of diabetes and severity of neuropathy.

Tummanapalli SS, Issar T, Yan A, et al. Corneal nerve fiber loss in diabetes with chronic kidney disease. Ocul Surf. November 23, 2019. [Epub ahead of print].