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October2011 Vol.48 Issue:        4        Table of Contents
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Correlation between Peripheral Neuropathy and Ocular Surface Disorders in Children and Adolescents with Type 1 Diabetes Mellitus

Ali S. Shalash1, Abeer A. Abdelmaksoud2, Amany A.  El-Shazly3,

Eman M. Abdel-Mohsen2, Mona A. Salem2

Departments of Neurology1, Pediatrics2, Ophthalmology3, Ain Shams University; Egypt


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:

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