Occurrence of corneal sub-epithelial microneuromas and axonal swelling in people with diabetes with and without (painful) diabetic neuropathy
An erratum to this article was published (Diabetologia, Jul 2024 ↗)
Authors' conclusion
Microneuromas and axonal swelling in the cornea increase in prevalence from participants with diabetes to participants with non-painful DSPN and participants with painful DSPN.
Study context
- Population
- People with and without diabetes, with and without (painful) distal symmetrical polyneuropathy (DSPN) diagnosed by clinical and electrodiagnostic criteria; corneal confocal microscopy
- Participants
- 27 / 33 / 25 / 18
- Exposure
- Corneal nerve morphology and microneuromas across diabetes and DSPN status
- Without diabetesn = 27reference
- Diabetes without DSPNn = 33
- Non-painful DSPNn = 25
- Painful DSPNn = 18
- Outcome
- Corneal nerve morphology and microneuromas
Methodological detailsANCOVA compared nerve morphology (central cornea, inferior whorl) and microneuroma numbers; Fisher's exact tests compared microneuroma type/presence and axonal swelling
- ANCOVA compared nerve morphology (central cornea, inferior whorl) and microneuroma numbers; Fisher's exact tests compared microneuroma type/presence and axonal swelling
Main finding
As reported in the abstract
- Corneal nerve morphology metrics (e.g. fibre length and density) showed a progressive decline across the groups
- p<0.001
- Axonal swelling present more frequently in painful vs non-painful DSPN
- p=0.018
- Axonal swelling in higher numbers in painful vs non-painful DSPN
- p=0.03
- Frequency of axonal distension (a microneuroma type) increased in painful and non-painful DSPN vs diabetes without DSPN and without diabetes
- all p≤0.042
- Combined presence of all microneuromas and axonal swelling increased in painful DSPN vs all other groups
- p≤0.026
Observational data: associations, not effects.
Original publication
Occurrence of corneal sub-epithelial microneuromas and axonal swelling in people with diabetes with and without (painful) diabetic neuropathy. Diabetologia. Published 10 June 2023. doi:10.
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