Dry Eye in Children and Adolescents With Type 1 Diabetes Is Closely Associated With Corneal Nerve Morphological Alterations.

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.