Background: Correlation between diabetic polyneuropathy (DPN),
corneal, and tear film disorders in young people with type 1 diabetes mellitus
(T1DM) has important clinical implications and needs further research. Objective: The
aim of this study is to evaluate the clinical characteristics of DPN in
children and adolescents with T1DM, and its relation to ocular surface
disorders. Methods: forty patients with T1DM and twenty controls were
included. Comprehensive clinical assessment was conducted for all patients.
Mean HbA1c and microalbuminuria over one year were estimated. Detailed
ophthalmological assessment included Schirmer, rose bengal staining,
fluorescein staining, tear break up time (BUT), impression cytology (IC) tests
and fundus examination. Neurological examination and nerve conduction study
(NCS) were conducted. Patients were subdivided into: group I for patients with
DPN and group II for patients without DPN. Results: All tear film tests except rose bengal were significantly
affected in patients (p<0.001). 19 patients (47%) were diagnosed to
have DPN. Patients with DPN had significantly lower tibial mean conduction
velocity (MCV) values (36.15± 7.29 versus 45.85 ± 2.43; p =0.01), longer
duration of diabetes (mean 6.6±3.09 versus 4.6±3.51 years; p= 0.03),
lower mean values of Schirmer (p= 0.001) and BUT (p = 0.0003)
tests, abnormal conjunctival IC and fluorescein staining tests (p= 0.007
and 0.035, respectively), compared with patients without DPN. Conclusion: DPN
is a common complication of T1DM, and related to age of patients, duration of
diabetes, and other chronic diabetic complications, and correlates with the
occurrence of ocular surface disorders. [Egypt J Neurol Psychiat Neurosurg. 2011; 48(4): 337-343]
Key Words:
diabetes mellitus, peripheral neuropathy, ocular surface disorders, tear film dysfunction.
Correspondence to Ali S. Shalash, Department of Neurology, Ain
Shams University, Egypt.
Tel.: +201005623036. Email: ali_neuro@yahoo.com.