Petropoulos Ioannis N, Alam Uazman, Fadavi Hassan, Asghar Omar, Green Patrick, Ponirakis Georgios, Marshall Andrew, Boulton Andrew J M, Tavakoli Mitra, Malik Rayaz A
Corresponding author: Rayaz A. Malik,
Diabetes Care. 2013 Nov;36(11):3646-51. doi: 10.2337/dc13-0193. Epub 2013 Jul 22.
To establish if corneal nerve loss, detected using in vivo corneal confocal microscopy (IVCCM), is symmetrical between right and left eyes and relates to the severity of diabetic neuropathy.
Patients (n = 111) with type 1 and type 2 diabetes and 47 age-matched healthy control subjects underwent detailed assessment and stratification into no (n = 50), mild (n = 26), moderate (n = 17), and severe (n = 18) neuropathy. IVCCM was performed in both eyes and corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) and the tortuosity coefficient were quantified.
All corneal nerve parameters differed significantly between diabetic patients and control subjects and progressively worsened with increasing severity of neuropathy. The reduction in CNFD, CNBD, and CNFL was symmetrical in all groups except in patients with severe neuropathy.
IVCCM noninvasively detects corneal nerve loss, which relates to the severity of neuropathy, and is symmetrical, except in those with severe diabetic neuropathy.
利用活体角膜共聚焦显微镜（IVCCM）检测角膜神经损伤，确定其在左右眼之间是否对称，以及是否与糖尿病神经病变的严重程度相关。
111例1型和2型糖尿病患者以及47例年龄匹配的健康对照者接受了详细评估，并被分为无神经病变组（n = 50）、轻度神经病变组（n = 26）、中度神经病变组（n = 17）和重度神经病变组（n = 18）。对双眼进行IVCCM检查，并对角膜神经纤维密度（CNFD）、分支密度（CNBD）、纤维长度（CNFL）和弯曲系数进行量化。
糖尿病患者与对照者之间所有角膜神经参数均有显著差异，且随着神经病变严重程度的增加而逐渐恶化。除重度神经病变患者外，所有组中CNFD、CNBD和CNFL的降低都是对称的。
IVCCM可无创检测角膜神经损伤，其与神经病变的严重程度相关，且是对称的，但重度糖尿病神经病变患者除外。
