School of Optometry & Vision Science, University of New South Wales, Sydney, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
Transl Vis Sci Technol. 2021 Jan 12;10(1):24. doi: 10.1167/tvst.10.1.24. eCollection 2021 Jan.
Sub-basal corneal nerves have been shown to change during neurotoxic chemotherapy treatment. This cross-sectional study investigated corneal nerve morphology in patients who have completed neurotoxic chemotherapy well after treatment cessation and its association with peripheral nerve function.
Central corneal nerve fiber length (CNFL) and inferior whorl length (IWL), average nerve fiber length (ANFL), corneal nerve fiber density (CNFD) and corneal nerve branch density (CNBD), and nerve fiber area (CNFA) were examined using in vivo corneal confocal microscopy in patients with cancer who had completed treatment with either paclitaxel or oxaliplatin between 3 and 24 months prior to assessment in comparison with 2 separate groups of healthy controls. Neurological assessments were conducted including clinician- and patient-reported outcomes, and neurological grading scales.
Both paclitaxel- ( = 40) and oxaliplatin-treated ( = 30) groups had reduced IWL and ANFL compared to the respective healthy control groups ( = 15 in each group) (paclitaxel: IWL = = 0.02, ANFL = = 0.009; and oxaliplatin: IWL = = 0.008, ANFL = 0.02). CNFL and CNFD reduction were observed only in the paclitaxel-treated group compared with healthy controls ( = 0.008 and = 0.02, respectively), whereas CNFA was reduced in the oxaliplatin-treated group ( = 0.04). IWL reduction correlated with worse fine hand dexterity in chemotherapy-treated patients ( = -0.33, = 0.007).
There is evidence of corneal nerve loss in patients with cancer who have been treated with paclitaxel and oxaliplatin well after treatment cessation associated with worse upper limb function.
Sub-basal corneal nerve reduction is evident even after cessation of neurotoxic treatment. In vivo corneal confocal microscopy may be useful in the monitoring of nerve function in patients receiving chemotherapy.
已有研究表明，亚基底角膜神经在神经毒性化疗治疗过程中会发生变化。本横断面研究调查了癌症患者在停止神经毒性化疗治疗数月后角膜神经形态及其与周围神经功能的关系，这些患者已完成治疗。
采用活体共聚焦角膜显微镜检查，对接受紫杉醇或奥沙利铂治疗并在评估前 3 至 24 个月完成治疗的癌症患者（每组各 40 例）的中央角膜神经纤维长度（CNFL）和下神经环长度（IWL）、平均神经纤维长度（ANFL）、角膜神经纤维密度（CNFD）和角膜神经分支密度（CNBD）以及神经纤维面积（CNFA）进行检测，并与两组健康对照组（每组 15 例）进行比较。进行了神经学评估，包括临床医生和患者报告的结果以及神经学分级量表。
与各自的健康对照组相比，紫杉醇组（ = 40）和奥沙利铂组（ = 30）的 IWL 和 ANFL 均降低（紫杉醇：IWL = = 0.02，ANFL = = 0.009；奥沙利铂：IWL = = 0.008，ANFL = 0.02）。仅在紫杉醇治疗组中观察到 CNFL 和 CNFD 降低与健康对照组相比（分别为 = 0.008 和 = 0.02），而在奥沙利铂治疗组中观察到 CNFA 降低（ = 0.04）。IWL 降低与化疗患者精细手部灵巧度降低相关（ = -0.33， = 0.007）。
停止治疗后，接受紫杉醇和奥沙利铂治疗的癌症患者存在角膜神经丢失的证据，且与上肢功能恶化有关。
本译文仅供参考，如遇专业需求，请寻求专业人士帮助。
