用于评估糖尿病周围神经病变的角膜共焦显微镜检查：一项荟萃分析。

Corneal confocal microscopy for assessment of diabetic peripheral neuropathy: a meta-analysis.

作者信息

Jiang Min-Shan, Yuan Ying, Gu Zhao-Xiang, Zhuang Song-Lin

机构信息

Shanghai Key Lab of Modern Optical Systems, Engineering Research Center of Optical Instruments and Systems, Ministry of Education, University of Shanghai for Science and Technology, Shanghai, China Department of Biomedical Engineering, Florida International University, Miami, Florida, USA.

Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.

出版信息

Br J Ophthalmol. 2016 Jan;100(1):9-14. doi: 10.1136/bjophthalmol-2014-306038. Epub 2015 Feb 12.

DOI:10.1136/bjophthalmol-2014-306038

PMID:25677672

Abstract

PURPOSE

To evaluate the diagnostic performance of corneal confocal microscopy (CCM) in assessing corneal nerve parameters in patients with diabetic peripheral neuropathy (DPN).

METHODS

Studies in the literature that focused on CCM and DPN were retrieved by searching PubMed, Excerpt Medica Database (EMBASE) and China National Knowledge Infrastructure (CNKI) databases. RevMan V.5.3 software was used for the meta-analysis. The results are presented as weighted mean difference (WMD) with a corresponding 95% CI.

RESULTS

13 studies with a total of 1680 participants were included in the meta-analysis. The pooled results showed that the corneal nerve fibre density, nerve branch density and nerve fibre length were significantly reduced (all p<0.00001) in the patients with DPN compared with healthy controls ((WMD=-18.07, 95% CI -21.93 to -14.20), (WMD=-25.35, 95% CI -30.96 to -19.74) and (WMD=-6.37, 95% CI -7.44 to -5.30)) and compared with the diabetic patients without DPN ((WMD=-8.83, 95% CI -11.49 to -6.17), (WMD=-13.54, 95% CI -20.41 to -6.66) and (WMD=-4.19, 95% CI -5.35 to -3.04)), respectively. No significant difference was found in the corneal nerve fibre tortuosity coefficient between diabetic patients with DPN and healthy controls (p=0.80) or diabetic patients without DPN (p=0.61).

CONCLUSIONS

This meta-analysis suggested that CCM may be valuable for detecting and assessing early nerve damage in DPN patients.

摘要

目的

评估角膜共焦显微镜（CCM）在评估糖尿病周围神经病变（DPN）患者角膜神经参数方面的诊断性能。

方法

通过检索PubMed、医学文摘数据库（EMBASE）和中国知网（CNKI）数据库，获取聚焦于CCM和DPN的文献研究。使用RevMan V.5.3软件进行荟萃分析。结果以加权平均差（WMD）及相应的95%置信区间表示。

结果

荟萃分析纳入了13项研究，共1680名参与者。汇总结果显示，与健康对照组相比，DPN患者的角膜神经纤维密度、神经分支密度和神经纤维长度均显著降低（均p<0.00001）（WMD=-18.07，95%置信区间 -21.93至-14.20）、（WMD=-25.35，95%置信区间 -30.96至-19.74）和（WMD=-6.37，95%置信区间 -7.44至-5.30）），与无DPN的糖尿病患者相比（WMD=-8.83，95%置信区间 -11.49至-6.17）、（WMD=-13.54，95%置信区间 -20.41至-6.66）和（WMD=-4.19，95%置信区间 -5.35至-3.04））。DPN糖尿病患者与健康对照组之间（p=0.80）或无DPN的糖尿病患者之间（p=0.61）的角膜神经纤维弯曲系数无显著差异。