Abicca Irene, Giannini Daniela, Gilardi Marta, Roszkowska Anna Maria, Parravano Mariacristina, Picconi Fabiana, Frontoni Simona, Schiano-Lomoriello Domenico
IRCCS-Fondazione Bietti, Rome, Italy.
Ophthalmic Hospital of Rome, Rome, Italy.
Front Med (Lausanne). 2022 May 12;9:897259. doi: 10.3389/fmed.2022.897259. eCollection 2022.
Peripheral neuropathy could complicate diabetes mellitus (DM). confocal microscopy (IVCM) is an ocular examination for the diagnosis of small fiber neuropathies and the detection of the earliest corneal sub-basal nerve plexus (SBP) alterations. Corneal SBP characteristics include focal enlargement along with the nerve fiber, called corneal beadings. These dilatations represent a mitochondrial accumulation induced by the reactive oxygen stress, as a consequence of hyperglycemia. For this reason, corneal beadings are considered indicative of metabolic activity. This study aimed to describe the corneal characteristics of a population of type 1 diabetes mellitus (T1DM) well metabolically controlled, using a new algorithm for the analysis of corneal beading size (BS).
Patients aged ≥18 years affected by T1DM were compared with healthy subjects who underwent IVCM (Confoscan 4; Nidek Technologies Padova, Italy). Starting from the coordinates of the beadings detected by the IVCM, we implemented a new algorithm for automatically measuring BS in corneal SBP images.
We compared 20 eyes of T1DM patients with 26 healthy controls. The corneal nerves' fiber length ( = 0.008), corneal nerves' fiber length density ( = 0.008), and the number of fibers ( = 0.017) were significantly lower in the diabetic group compared with controls. There was no difference between diabetic and healthy eyes in the mean number of corneal beadings both in the frame of analysis ( = 0.606) and for 0.1 mm of SBP nerve ( = 0.145). Regarding the BS, patients with T1DM had corneal beadings larger than controls ( = 0.036).
We found that the corneal beadings parameters are similar in healthy and T1DM individuals. Nevertheless, measuring the BS with our algorithm, we showed that corneal beadings are enlarged in patients affected by T1DM when compared with healthy controls. Identifying beading expansion in corneal nerve fiber using IVCM should become a useful tool to predict peripheral neuropathy at an early stage.
周围神经病变可能使糖尿病（DM）复杂化。共聚焦显微镜检查（IVCM）是一种用于诊断小纤维神经病变和检测最早的角膜基底神经丛（SBP）改变的眼部检查方法。角膜SBP的特征包括沿神经纤维的局灶性增粗，称为角膜串珠。这些扩张代表了由高血糖引起的活性氧应激诱导的线粒体积累。因此，角膜串珠被认为是代谢活性的指标。本研究旨在使用一种新的算法分析角膜串珠大小（BS），描述代谢控制良好的1型糖尿病（T1DM）患者群体的角膜特征。
将年龄≥18岁的T1DM患者与接受IVCM检查（Confoscan 4；意大利帕多瓦尼德克技术公司）的健康受试者进行比较。从IVCM检测到的串珠坐标开始，我们实施了一种新算法，用于自动测量角膜SBP图像中的BS。
我们将20只T1DM患者的眼睛与26名健康对照者进行了比较。与对照组相比，糖尿病组的角膜神经纤维长度（=0.008）、角膜神经纤维长度密度（=0.008）和纤维数量（=0.0得17）显著降低。在分析框架内（=0.606）和SBP神经0.1mm范围内，糖尿病眼和健康眼的角膜串珠平均数量没有差异（=0.145）。关于BS，T1DM患者的角膜串珠比对照组大（=0.036）。
我们发现健康个体和T1DM个体的角膜串珠参数相似。然而，使用我们的算法测量BS时，我们发现与健康对照相比，T1DM患者的角膜串珠增大。使用IVCM识别角膜神经纤维中的串珠扩张应成为早期预测周围神经病变的有用工具。
