Non-Contact Esthesiometry As A Potential Independent Biomarker For Monitoring Diabetic Eye Disease Severity
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR424 | Type: Free paper | DOI: 10.82333/6pz8-3895
Authors: Dr Luigi Apa* 1 , A/Prof. Maurizio Mete 1 , Dr Nicola Valsecchi 1 , Dr Natalie di Geronimo 2 , A/Prof. Piera Versura 1 , A/Prof. Antonio Moramarco 3 , A/Prof. Luigi Fontana 1
1DIMEC,Ophthalmology Unit, Alma Mater Studiorum University of Bologna,Bologna,Italy, 2Ophthalmology Unit, IRCCS AOU di Bologna Policlinico di Sant'Orsola,Bologna,Italy, 3DIMEC,Ophthalmology Unit, Alma Mater Studiorum University of Bologna,Bologna,Italy;Ophthalmology Unit, Santa Maria delle Croci Hospital,Ravenna,Italy
Purpose
To evaluate corneal sensitivity in diabetes mellitus (DM) using a non-contact esthesiometer and its relationship with diabetic retinopathy (DR) severity and systemic glycemic parameters.
Setting
Retina Clinic and Cornea and Ocular Surface Laboratory, Ophthalmology Unit at Alma Mater Studiorum University of Bologna.
Methods
In this case-control study, we recruited 60 patients with diabetes mellitus (DM; 120 eyes) and 30 age-matched healthy controls (60 eyes). The diabetic cohort was stratified based on the severity of diabetic retinopathy (DR) into three groups: no DR, non-proliferative DR (NPDR), and proliferative DR (PDR). Systemic glycemic status was documented by recording fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) levels. To assess corneal sensory function, mean corneal sensitivity thresholds (CST) were determined across five corneal quadrants using the Brill® non-contact esthesiometer (NCE). Multivariate analysis using generalized estimating equations was performed to identify variables associated with higher CST.
Results
Mean CST was significantly higher in diabetic eyes compared to healthy controls (6.5 ± 1.2 vs. 3.3 ± 1.0 mBar; p < 0.001), indicating a substantial reduction in corneal sensory function. A progressive, significant increase in CST was observed as the severity of DR worsened: 5.0 ± 1.4 mBar for no DR, 6.2 ± 1.8 mBar for NPDR, and 9.9 ± 2.5 mBar for PDR (p < 0.001). In the multivariate regression model, DR stage emerged as the sole independent predictor of elevated CST (B = 2.195; 95% CI, 0.123–5.076; p = 0.027). Notably, clinical and metabolic factors—including age, sex, disease duration, FPG, and HbA1c—as well as ocular variables such as pseudophakia and prior laser treatment, did not demonstrate significant associations
Conclusions
Corneal sensitivity exhibited a progressive decline in tandem with advancing DR severity, remaining independent of demographic variables and systemic glycemic fluctuations. The Brill® NCE represents a reliable, non-invasive modality for the early detection of diabetic keratopathy and potentially serves as a stable functional biomarker for neuro-structural ocular involvement in DM.