Szalai Eszter, Deák Eszter, Módis László, Németh Gábor, Berta András, Nagy Annamária, Felszeghy Eniko, Káposzta Rita, Malik Rayaz A, Csutak Adrienne
Department of Ophthalmology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary.
Department of Ophthalmology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary 2Department of Biochemistry and Molecular Biology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary.
Invest Ophthalmol Vis Sci. 2016 Mar;57(3):853-8. doi: 10.1167/iovs.15-18735.
The aim of this study was to quantify epithelial, stromal, and endothelial cell density, and subbasal nerve morphology in young patients with type 1 diabetes mellitus with and without diabetic retinopathy.
A total of 28 young patients (mean age, 22.86 ± 9.05 years) with type 1 diabetes, with (n = 18) and without (n = 10) retinopathy, and 17 age-matched healthy control subjects (mean age, 26.53 ± 2.43 years) underwent corneal confocal microscopy (CCM).
We found significantly lower epithelial (P < 0.0001) and endothelial (P = 0.001) cell densities and higher keratocyte cell density (P = 0.024) in patients with type 1 diabetes compared to controls. Significantly lower corneal nerve fiber density (P = 0.004), nerve branch density (P = 0.004), total nerve branch density (P = 0.04), and nerve fiber length (P = 0.001), and greater nerve fiber width (P = 0.04) were observed in patients with type 1 diabetes compared to control subjects. Significantly lower epithelial (P < 0.001) and endothelial (P = 0.02) cell densities, nerve branch density (P = 0.02), and nerve fiber length (P = 0.04), and significantly higher keratocyte cell density (P = 0.02) were found in patients with type 1 diabetes without retinopathy compared to control subjects.
Corneal confocal microscopy identifies corneal cellular and small nerve fiber pathology in young patients with type 1 diabetes without retinopathy, which increases in severity in those with retinopathy. Corneal confocal microscopy appears to have considerable use as an imaging biomarker for early subclinical pathology in young patients with type 1 diabetes mellitus.
本研究旨在量化1型糖尿病年轻患者有无糖尿病视网膜病变时的上皮细胞、基质细胞和内皮细胞密度，以及基底膜下神经形态。
共有28例1型糖尿病年轻患者（平均年龄22.86±9.05岁），其中有视网膜病变的18例，无视网膜病变的10例，以及17例年龄匹配的健康对照者（平均年龄26.53±2.43岁）接受了角膜共焦显微镜检查（CCM）。
我们发现，与对照组相比，1型糖尿病患者的上皮细胞（P<0.0001）和内皮细胞密度（P=0.001）显著降低，角膜细胞密度更高（P=0.024）。与对照组相比，1型糖尿病患者的角膜神经纤维密度（P=0.004）、神经分支密度（P=0.004）、总神经分支密度（P=0.04）和神经纤维长度（P=0.001）显著降低，神经纤维宽度更大（P=0.04）。与对照组相比，无视网膜病变的1型糖尿病患者的上皮细胞（P<0.001）和内皮细胞密度（P=0.02）、神经分支密度（P=0.02）和神经纤维长度（P=0.04）显著降低，角膜细胞密度显著更高（P=0.02）。
角膜共焦显微镜检查可发现无视网膜病变的1型糖尿病年轻患者的角膜细胞和小神经纤维病变，在有视网膜病变的患者中病变严重程度增加。角膜共焦显微镜检查似乎可作为1型糖尿病年轻患者早期亚临床病变的重要成像生物标志物。
