Yu Mingyi, Ning Faith Teo En, Liu Chang, Liu Yu-Chi
Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Neural Regen Res. 2025 Aug 1;20(8):2169-2180. doi: 10.4103/NRR.NRR-D-24-00509. Epub 2024 Sep 20.
Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus. Diabetic corneal neuropathy refers to the progressive damage of corneal nerves. Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature. However, growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit, which includes both the retinal vascular structures and neural tissues. Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening. However, diabetic corneal neuropathy is commonly overlooked and underdiagnosed, leading to severe ocular surface impairment. Several studies have found that these two conditions tend to occur together, and they share similarities in their pathogenesis pathways, being triggered by a status of chronic hyperglycemia. This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy, whether diabetic corneal neuropathy precedes diabetic retinopathy, as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy. We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.
糖尿病性角膜神经病变和糖尿病性视网膜病变是糖尿病患者出现的眼部并发症。糖尿病性角膜神经病变是指角膜神经的进行性损伤。传统上，糖尿病性视网膜病变被认为是视网膜微血管系统的损伤。然而，越来越多的证据表明，糖尿病性视网膜病变是一种复杂的神经血管疾病，由神经血管单元功能障碍引起，该单元包括视网膜血管结构和神经组织。糖尿病性视网膜病变是导致失明的主要原因之一，并且经常作为糖尿病眼部筛查的一部分进行检查。然而，糖尿病性角膜神经病变通常被忽视和漏诊，导致严重的眼表损害。多项研究发现，这两种情况往往同时出现，并且它们在发病机制途径上具有相似性，均由慢性高血糖状态引发。本综述旨在探讨糖尿病性角膜神经病变与糖尿病性视网膜病变之间的联系、糖尿病性角膜神经病变是否先于糖尿病性视网膜病变，以及糖尿病性视网膜病变的阶段与角膜神经病变严重程度之间的关系。我们还致力于探讨在糖尿病患者眼部进行角膜筛查的相关性，以及利用角膜神经测量来监测糖尿病性视网膜病变进展的可能性。
