Neurotrophic keratopathy and corneal ulcers in diabetes mellitus

Diabetes mellitus is a chronic metabolic disease associated with numerous complications, including diabetic keratopathy. This frequently underestimated disease can lead to reduced corneal sensitivity, neurotrophic ulcers and potentially sight-threatening infections. In this retrospective analysis of the subgroup of 136,992 machine-readable health records recruited from all patients who presented to our university outpatient clinic between January 2003 and February 2024, we investigated the association between diabetes mellitus, neurotrophic keratopathy and corneal ulcers. Of the patients 3168 had corneal ulcers (prevalence 2.3%) and 11,338 had diabetes mellitus (8%). The results showed that diabetes mellitus significantly increased the risk of corneal ulcers (odds ratio, OR 1.18; 95% confidence interval, CI 1.04-1.32) and neurotrophic keratopathy (OR 1.78; 95% CI 1.20-2.56). In addition, older age and male gender were risk factors. In the reverse analysis, corneal ulcers were shown to be significant predictors of the presence of diabetes mellitus. Our results underline the need for regular ophthalmological check-ups and diabetes mellitus screening in patients with corneal complications in order to intervene at an early stage and prevent severe consequences such as loss of vision.