Evaluation of corneal stromal and endotelial alterations of type 1 and TYPE 2 non--proliferative diabetic patients with confocal microscopy

Purpose: Herein we planned to investigate the probable effects of diabetes on cornea in a group of patients without any clinical retinal findings. With confocal microscopy we analyzed angulation of subbasal nerve and densities of the subbasal coneal nerve plexus, stromal keratocyte and endotelial cells and we compare our findings with those of nondiabetic patients.Methods: Thirty-five corneas of patients with type 2 diabetes and 24 corneas of age-matched control subjects were included in the study. Patients with diabetes were further divided as Type 1 and 2 (Group 1 and 2). Also control patients were divided into 2 groups (group 3 and 4) for creation of age-match control groups. With Heidelberg RetinaTomograph Rosstock Corneal Module laser scanning confocal mikroskop HRT3 we analyzed angulation of subbasal nerve and densities of the subbasal coneal nerve plexus, stromal keratocyte and endotelial cells.Results: Mean age of patients were 25.2, 53.1, 24.2, 51.5, respectively and there was not any statsitical difference between groups 1 and 3 or groups 2 and 4. Among investigated parameters we detect statistical significant difference for endotelial and keratocyte cell densities between groups 1 and 3 (3238 vs 3596 and 304 and 547) and groups 2 and 4 (2527 vs 3231 and 318 vs 496) (p<0.05). O the other hand, for nerve density plexus density and nerve angulation the statistical difference was obtained between groups 1 and 3 (51 vs 75 and 49 vs 21º) (p<0.05) but not for group 2 and 4 (58 vs 63) (28 vs 23º) (p>0.05).Conclusion: With that study we documented that cornea could be effected in diabetic patients even in cases without any retinal findings. Developing technologies could provide new oppurtunities for more earlier detection of diabetic findings on cornea.