Abstract
PURPOSE. This study investigated the expression of insulin-like growth factor binding protein-3 (IGFBP-3) in basal tears of patients with type 2 diabetes mellitus compared to nondiabetic controls; and correlated tear levels of IGFBP-3 with morphologic changes in the subbasal nerve plexus and density of basal corneal epithelial cells. METHODS. This was a single visit, cross-sectional study. Diabetic and control subjects were matched for age, sex, smoking status, and body mass index. Tear levels of IGFBP-3 were measured using ELISA. Corneal nerve and basal epithelial cell changes were measured using in vivo confocal microscopy. RESULTS. Tear levels of IGFBP-3 were 3.5-fold higher in those with diabetes. Patients with diabetes also showed a reduction in nerve fiber layer, nerve branch density, and corneal basal epithelial cell density. There was no significant difference in corneal sensitivity. IGFBP-3 levels were highly correlated with nerve fiber length and branch density; while hemoglobin (Hb)A1c was only moderately correlated. There were no significant differences in the clinical or subjective signs of dry eye between groups, indicating that tear levels of IGFBP-3 and corneal nerve changes were not due to the presence of mild dry eye. CONCLUSIONS. These findings indicate that tear levels of IGFBP-3 are more tightly correlated to nerve fiber changes in diabetes than HbA1c. Future studies that stratify the severity of diabetic disease with tear levels of IGFBP-3 are needed to validate this finding.
Original language | English (US) |
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Pages (from-to) | 6105-6112 |
Number of pages | 8 |
Journal | Investigative Ophthalmology and Visual Science |
Volume | 58 |
Issue number | 14 |
DOIs | |
State | Published - Dec 2017 |
Keywords
- Cornea
- Epithelium
- IGFBP-3
- Subbasal nerve plexus
- T2DM
ASJC Scopus subject areas
- Ophthalmology
- Sensory Systems
- Cellular and Molecular Neuroscience