Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Nepal J Ophthalmol. 2020 Jul;12(24):201-208. doi: 10.3126/nepjoph.v12i2.27972.
Corneal autofluorescence (AF) has been recommended as an indicator of diabetic retinopathy. This study was conducted to evaluate corneal autofluorescence in non-insulin dependent diabetes subjects (with and without diabetic retinopathy) and compare the changes with healthy subjects.
In this cross-sectional study, 145 eyes of diabetes mellitus subjects with and without diabetic retinopathy and 34 eyes of normal healthy subjects were included. Diabetic patients were subdivided by the severity of retinopathy based on international clinical diabetic retinopathy disease severity scale. The investigations included fluorophotometric determination of corneal autofluorescence, fasting glucose level (FBS) and glycosylated hemoglobin (HbA1c).
The corneal autofluorescence values were significantly higher in moderate NPDR, severe NPDR and PDR when compared with healthy subjects (p<0.001). FBS values and HbA1c were significantly higher in all diabetic groups than the healthy subjects (p<0.001). In linear regression test, corneal autofluorescence seem to be related to duration of diabetes and FBS, but not with age and HbA1c.
We conclude that the level of corneal autofluorescence is dependent on the severity of diabetic retinopathy. Our study suggests that the formation of autofluorescent products in cornea depend upon the glucose concentration in the aqueous humor.
角膜自发荧光（AF）已被推荐为糖尿病视网膜病变的指标。本研究旨在评估非胰岛素依赖型糖尿病患者（伴或不伴糖尿病视网膜病变）的角膜自发荧光，并与健康受试者进行比较。
在这项横断面研究中，纳入了 145 只伴有或不伴有糖尿病视网膜病变的糖尿病患者的眼和 34 只正常健康受试者的眼。糖尿病患者根据国际临床糖尿病视网膜病变疾病严重程度量表按视网膜病变的严重程度进行细分。调查包括角膜自发荧光的荧光光度测定、空腹血糖（FBS）和糖化血红蛋白（HbA1c）。
与健康受试者相比，中度 NPDR、重度 NPDR 和 PDR 的角膜自发荧光值明显升高（p<0.001）。所有糖尿病组的 FBS 值和 HbA1c 值均明显高于健康组（p<0.001）。在线性回归试验中，角膜自发荧光似乎与糖尿病的持续时间和 FBS 有关，但与年龄和 HbA1c 无关。
我们得出结论，角膜自发荧光的水平取决于糖尿病视网膜病变的严重程度。我们的研究表明，角膜中自发荧光产物的形成取决于房水中的葡萄糖浓度。
