Department of Ophthalmology, University of Pécs Medical School, Pécs, Hungary.
Transl Vis Sci Technol. 2023 Mar 1;12(3):24. doi: 10.1167/tvst.12.3.24.
The purpose of this study was to assess whether retinal microvascular or corneal nerve abnormalities occur earlier in diabetes mellitus (DM) and to identify imaging biomarkers in order to help prevent the subsequent irreversible retinal and corneal complications.
The study comprised 35 eyes of 35 healthy volunteers and 52 eyes of 52 patients with type 1 and type 2 DM. Swept-source optical coherence tomography (OCT), OCT angiography, and in vivo corneal confocal microscopy were performed in both groups. Corneal sub-basal nerve plexus and vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were evaluated.
All corneal sub-basal nerve fiber parameters were decreased in patients with DM compared with healthy subjects and the difference was significant for each result except for nerve fiber width (P = 0.586). No significant correlation was obtained between any nerve fiber morphology parameters and disease duration or HbA1C. VD in SCP was significantly decreased in the superior (P < 0.0001), temporal (P = 0.001), and nasal quadrant (P = 0.003) in the diabetes group. In DCP, only superior VD (P = 0.036), decreased significantly in the diabetes group. Ganglion cell layer thickness in the inner ring showed a significantly lower value in patients with DM (P < 0.0001).
Our results implicate a more pronounced and earlier damage to the corneal nerve fibers compared to the retinal microvasculature in patients with DM.
In DM, an earlier and more pronounced damage to the corneal nerve fibers was observed compared to the retinal microvasculature.
本研究旨在评估糖尿病患者（DM）的视网膜微血管或角膜神经异常是否更早发生，并确定成像生物标志物，以帮助预防随后不可逆的视网膜和角膜并发症。
本研究纳入了 35 名健康志愿者的 35 只眼和 52 名 1 型和 2 型 DM 患者的 52 只眼。对两组患者均进行了扫频源光学相干断层扫描（OCT）、OCT 血管造影和活体角膜共聚焦显微镜检查。评估角膜基底神经丛和浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）的血管密度（VD）。
与健康受试者相比，DM 患者的所有角膜基底神经纤维参数均降低，除神经纤维宽度（P = 0.586）外，其余结果均有统计学意义。任何神经纤维形态参数与疾病持续时间或糖化血红蛋白（HbA1C）均无显著相关性。SCP 的上象限（P < 0.0001）、颞象限（P = 0.001）和鼻象限（P = 0.003）的 VD 在糖尿病组中均显著降低。在 DCP 中，只有上象限的 VD（P = 0.036）在糖尿病组中显著降低。内圈的神经节细胞层厚度在 DM 患者中表现出明显较低的值（P < 0.0001）。
与糖尿病患者的视网膜微血管相比，我们的结果表明角膜神经纤维的损伤更为明显和更早。
本文是对英文文献的翻译，仅供参考。
