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This study aimed to further explore corneal nerve fibre pathology in diabetic neuropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study quantified and compared corneal nerve morphology and microneuromas in participants without diabetes (\n                      <jats:italic>n<\/jats:italic>\n                      =27), participants with diabetes but without distal symmetrical polyneuropathy (DSPN;\n                      <jats:italic>n<\/jats:italic>\n                      =33), participants with non-painful DSPN (\n                      <jats:italic>n<\/jats:italic>\n                      =25) and participants with painful DSPN (\n                      <jats:italic>n<\/jats:italic>\n                      =18). Clinical and electrodiagnostic criteria were used to diagnose DSPN. ANCOVA was used to compare nerve fibre morphology in the central cornea and inferior whorl, and the number of corneal sub-epithelial microneuromas between groups. Fisher\u2019s exact tests were used to compare the type and presence of corneal sub-epithelial microneuromas and axonal swelling between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Various corneal nerve morphology metrics, such as corneal nerve fibre length and density, showed a progressive decline across the groups (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). In addition, axonal swelling was present more frequently (\n                      <jats:italic>p<\/jats:italic>\n                      =0.018) and in higher numbers (\n                      <jats:italic>p<\/jats:italic>\n                      =0.03) in participants with painful compared with non-painful DSPN. The frequency of axonal distension, a type of microneuroma, was increased in participants with painful and non-painful DSPN compared to participants with diabetes but without DSPN and participants without diabetes (all\n                      <jats:italic>p<\/jats:italic>\n                      \u22640.042). The combined presence of all microneuromas and axonal swelling was increased in participants with painful DSPN compared with all other groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u22640.026).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>Microneuromas and axonal swelling in the cornea increase in prevalence from participants with diabetes to participants with non-painful DSPN and participants with painful DSPN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-023-05945-0","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T14:01:18Z","timestamp":1686405678000},"page":"1719-1734","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Occurrence of corneal sub-epithelial microneuromas and axonal swelling in people with diabetes with and without (painful) diabetic neuropathy"],"prefix":"10.1007","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4534-8564","authenticated-orcid":false,"given":"Eva","family":"Sierra-Silvestre","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5316-7531","authenticated-orcid":false,"given":"Ricardo J.","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5588-2659","authenticated-orcid":false,"given":"Luisa H.","family":"Colorado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7746-4848","authenticated-orcid":false,"given":"Katie","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3958-4408","authenticated-orcid":false,"given":"Michel W.","family":"Coppieters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,10]]},"reference":[{"key":"5945_CR1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/1478-7954-8-29","volume":"8","author":"JP Boyle","year":"2010","unstructured":"Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF (2010) Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. 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ES-S, LH-C and KE collected the data, and ES-S, RJA and MWC performed the data analysis and data interpretation. ES-S, LH-C, KE and MWC prepared the various drafts of the manuscript. All authors critically revised the manuscript and approved the final version of the manuscript. MWC is the guarantor of this work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}