Corneal Sensitivity Is Inversely Correlated With Severity of Diabetic Retinopathy in a Predominantly Underrepresented Population

Abstract

PurposeTo assess the relationship between diabetic retinopathy (DR) and corneal sensitivity. MethodsIn this prospective study, 100 eyes of 50 patients from primarily underrepresented racial and ethnic backgrounds with DR underwent assessment of corneal sensitivity using a Cochet-Bonnet esthesiometer. Severity of DR was graded by a masked reading center. Corneal sensitivity was compared in eyes with current or regressed proliferative DR (PDR) (n=35) and eyes with non-proliferative DR (NPDR) with no history of PDR (n=65). Corneal sensitivity in eyes that regressed from PDR to NPDR with anti-vascular endothelial growth factor (VEGF) therapy (n=7) was compared to treatment-naïve eyes with no current or prior PDR (n=55) and to eyes with newly diagnosed, treatment-naïve PDR (n=12). ResultsIn eyes with current or prior PDR, the median corneal sensitivity (average of 4 quadrants) was 0.5 cm (IQR 0-3.375), while in eyes with no current or prior PDR, the median corneal sensitivity was 4.75 cm (IQR 2.0-6.0, P<.0001). The median corneal sensitivity in eyes with regressed PDR was 0 cm (IQR 0-0.875), significantly lower than eyes with no current or prior PDR (4.5 cm, IQR 4.0, P=.0076) and no different than eyes with untreated PDR (0 cm, IQR 1.25). The odds of eyes with DRSS ≥ 60 having complete corneal sensitivity loss was 3.6 times that of eyes with NPDR. ConclusionsCorneal sensitivity is impaired in eyes with PDR compared to NPDR, and is not rescued by anti-VEGF therapy. Assessment of corneal sensitivity in eyes with DR may identify patients at risk for additional complications including neurotrophic keratopathy.