Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Invest Ophthalmol Vis Sci. 2013 Jul 2;54(7):4485-90. doi: 10.1167/iovs.12-10571.
To assess the effects of panretinal photocoagulation (PRP) for diabetic retinopathy (DR) on the human corneal subbasal nerve plexus (SBNP) and to investigate correlations between corneal subbasal nerve (SBN) density, corneal sensitivity, and diabetic peripheral neuropathy.
Thirty-eight subjects with at least a 10-year history of diabetes mellitus (DM) or DR were included. Subjects were assigned to a PRP group (n = 19), having undergone a treatment of retinopathy in at least one eye or a non-PRP group (n = 19), with no history of PRP. The Michigan Neuropathy Screening Instrument (MNSI) was administered to enable quantification of neuropathic symptoms. Laser scanning in vivo confocal microscopy was performed to capture images of the corneal SBNP to allow determination of SBNP density. Central corneal sensitivity (CST) was evaluated by noncontact aesthesiometry and peripheral vibration perception threshold was measured with a biothesiometer.
Mean SBNP densities were 12.27 ± 4.28 mm/mm²) in the PRP group and 12.75 ± 3.59 mm/mm² in the non-PRP group. There were no significant differences in SBNP density (P = 0.71), CST (P = 0.84), MNSI score (P = 0.19), and biothesiometry (P = 0.77) between the PRP and non-PRP groups. When data from both groups (n = 38) were combined, corneal sensitivity was modestly correlated with SBNP density (r = 0.30, P = 0.06), and peripheral biothesiometry (r = 0.26, P = 0.11).
In DM correlation of corneal sensitivity, SBNP density, and peripheral biothesiometry may have a potential role in estimating the severity of peripheral neuropathy. Corneal SBNP density and sensitivity appear to be unaffected by PRP laser treatment compared with non-PRP diabetic eyes.
评估全视网膜光凝（PRP）治疗糖尿病视网膜病变（DR）对人角膜基底神经丛（SBNP）的影响，并研究角膜基底神经（SBN）密度、角膜敏感度与糖尿病周围神经病变之间的相关性。
纳入 38 名至少有 10 年糖尿病（DM）或 DR 病史的受试者。将受试者分为 PRP 组（n=19），至少有一只眼接受过视网膜病变治疗，或非 PRP 组（n=19），无 PRP 治疗史。采用密歇根神经病变筛查工具（MNSI）进行量化评估神经病变症状。进行激光共聚焦显微镜活体扫描以获取角膜 SBNP 图像，从而确定 SBNP 密度。采用非接触式知觉仪评估中央角膜敏感度（CST），使用生物感觉计测量外周振动感知阈值。
PRP 组的平均 SBNP 密度为 12.27±4.28mm/mm²，非 PRP 组为 12.75±3.59mm/mm²。两组间 SBNP 密度（P=0.71）、CST（P=0.84）、MNSI 评分（P=0.19）和生物感觉计（P=0.77）差异均无统计学意义。将两组（n=38）的数据合并后，角膜敏感度与 SBNP 密度（r=0.30，P=0.06）和外周生物感觉计（r=0.26，P=0.11）呈弱相关。
在 DM 中，角膜敏感度、SBNP 密度和外周生物感觉计之间的相关性可能在估计周围神经病变严重程度方面具有一定作用。与非 PRP 糖尿病眼相比，PRP 激光治疗似乎对角膜 SBNP 密度和敏感度没有影响。
