Decreased corneal subbasal nerve fiber length and density in diabetic dogs with cataracts using in vivo confocal microscopy

ObjectiveTo determine whether there is a difference in corneal sensitivity and corneal subbasal nerve plexus (CSNP) morphology in cataractous dogs with diabetes mellitus (DM) versus without DM. Animals studiedTwenty six domestic dogs with cataracts of various breeds presented for phacoemulsification, 13 with DM and 13 without DM. ProcedureThe inclusion criteria for the study were dogs with bilateral cataracts and no clinical evidence of corneal disease. The diabetic group had documented hyperglycemia and was currently treated with insulin. The non-diabetic group had no evidence of DM on examination and bloodwork. Complete ophthalmic examination, corneal esthesiometry, and in vivo confocal microscopy of the CSNP was performed for both eyes of each dog. The CSNP was evaluated using a semi-automated program and statistically analyzed. ResultsThe mean (+/- SD) CSNP fiber length was significantly decreased in diabetic (3.8 +/- 3.0 mm/mm(2)) versus non-diabetic (6.7 +/- 1.9 mm/mm(2)) dogs. Likewise, the mean (+/- SD) fiber density was significantly decreased in diabetic (8.3 +/- 3.1 fibers/mm(2)) versus non-diabetic (15.5 +/- 4.9 fibers/mm(2)) dogs. The corneal touch threshold was significantly reduced in diabetic (2.1 +/- 0.8 cm) versus non-diabetic (2.8 +/- 0.4 cm) dogs. There was a non-significant trend towards subclinical keratitis in diabetic (9/13) versus non-diabetic (4/13) dogs. ConclusionsMorphological and functional abnormalities of the CSNP were present in dogs with DM, including decreased fiber length, fiber density, and corneal sensitivity. These findings are consistent with diabetic neuropathy and could contribute to clinically significant corneal complications after cataract surgery.