Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Invest Ophthalmol Vis Sci. 2019 Feb 1;60(2):830-837. doi: 10.1167/iovs.18-24516.
We have previously used in vivo corneal confocal microscopy (IVCCM) to demonstrate significant alterations in the corneal epithelial cells, stromal keratocytes, and subbasal nerves in young patients with type 1 diabetes mellitis (T1DM), especially those with diabetic retinopathy (DR). We have evaluated the change in corneal cellular and subbasal nerve morphology over 2 years in young patients with T1DM with or without DR.
A total of 19 patients with T1DM, without (n = 12) and with (n = 7) DR and 19 age- and sex-matched healthy control subjects underwent quantification of corneal cellular and subbasal nerve plexus morphology by using IVCCM at baseline and after 2 years.
There was no significant change in corneal basal epithelial, posterior stromal keratocyte, or endothelial cell densities over 2 years. However, there was a significant reduction in corneal nerve branch (P = 0.03) and total nerve branch density (P = 0.04) in patients without DR and a significant reduction in corneal nerve fibre density (P = 0.004) in those with DR.
IVCCM can detect a progressive loss of corneal nerve fibers in young patients with T1DM and may allow the identification of individuals at risk of neuropathy progression for more active risk factor reduction.
我们先前曾使用活体角膜共聚焦显微镜（IVCCM）来证明 1 型糖尿病（T1DM）年轻患者的角膜上皮细胞、基质成纤维细胞和基底下神经出现明显改变，尤其是那些患有糖尿病视网膜病变（DR）的患者。我们评估了 2 年内无 DR（n=12）和有 DR（n=7）的 T1DM 年轻患者的角膜细胞和基底下神经形态的变化。
共有 19 名 T1DM 患者（无 DR 者 12 名，有 DR 者 7 名）和 19 名年龄和性别匹配的健康对照者接受了 IVCCM 检查，以在基线和 2 年后对角膜细胞和基底下神经丛形态进行定量评估。
2 年内角膜基底上皮、后基质成纤维细胞或内皮细胞密度无明显变化。然而，无 DR 的患者角膜神经分支（P=0.03）和总神经分支密度（P=0.04）显著减少，有 DR 的患者角膜神经纤维密度（P=0.004）显著减少。
IVCCM 可检测到 T1DM 年轻患者角膜神经纤维的进行性丧失，这可能有助于识别出神经病变进展风险较高的个体，以进行更积极的危险因素降低。
