Česká Burdová M, Lainová Vrabcová T, Dotřelová D, Mahelková G
Cesk Slov Oftalmol. 2017 Fall;73(4):161-167.
In vivo corneal confocal microscopy (CCM) represents a new, non-invasive, rapidly developing corneal examination technique that enables individual layers of the cornea to be displayed at the cellular level. The cornea is the translucent and at the same time the most innervated tissue of the human body. Diabetic neuropathy (DN) is a serious complication of diabetes mellitus (DM). A close correlation has been demonstrated between the development of diabetic neuropathy and the pathological changes of the corneal subbasal plexus. Currently, great attention is directed towards the possibility of using CCM to determine early DN. Interestingly, changes in nerve plexus in the cornea precede the clinical manifestations of DN. Our work aims to give a comprehensive overview of the current possibilities and trends in use of in vivo CCM in connection with DN evaluation. In vivo CCM becomes important in the search for patients at risk of developing DN, in early diagnosis of DN in pre-symptomatology, in quantifying severe DN, in monitoring and evaluating the therapeutic response to DM treatment. In addition to its diagnostic and preventive significance, it is a research tool important for understanding the pathophysiology of DM changes.Key words: confocal microscopy, cornea, small fibre neuropathy, diabetes mellitus, diabetic neuropathy.
体内角膜共焦显微镜检查(CCM)是一种新型的、非侵入性的、快速发展的角膜检查技术,能够在细胞水平显示角膜的各层结构。角膜是人体半透明且同时神经分布最丰富的组织。糖尿病性神经病变(DN)是糖尿病(DM)的一种严重并发症。糖尿病性神经病变的发展与角膜基底膜下神经丛的病理变化之间已证实存在密切关联。目前,人们高度关注利用CCM来确定早期DN的可能性。有趣的是,角膜神经丛的变化先于DN的临床表现出现。我们的工作旨在全面概述当前在DN评估中使用体内CCM的可能性和趋势。体内CCM在寻找有发生DN风险的患者、在症状前期对DN进行早期诊断、对严重DN进行量化、监测和评估DM治疗的疗效反应方面变得至关重要。除了其诊断和预防意义外,它还是一种对于理解DM变化的病理生理学很重要的研究工具。关键词:共焦显微镜检查、角膜、小纤维神经病变、糖尿病、糖尿病性神经病变