Fantaguzzi S, Docchio F, Guarisco L, Brancato R
Department of Ophthalmology, University of Milano, Scientific Institute H-S. Raffaele, Italy.
Int Ophthalmol. 1994;18(4):211-4. doi: 10.1007/BF00951799.
Corneal autofluorescence has been lately studied as a predictor of retinopathy severity in diabetic patients. We measured corneal autofluorescence in 138 eyes of 69 diabetic patients and 64 eyes of 32 healthy controls. Diabetic patients were subdivided by the severity of retinopathy according to the Modified Airlie House Classification (stage 1: no or minimal retinopathy; stage 2: minimal background retinopathy; stage 3: background retinopathy; stage 4: (pre-) proliferative retinopathy. The fluorescence peak value and the area underlying the corneal autofluorescence curve were measured with a scanning fluorophotometer (Fluorotron Master, Coherent Radiation Palo Alto CA) Healthy controls' values of corneal autofluorescence (peak value: mean 11.03 +/- 3.77 ng. equivalent fluorescein/ml; area: mean 163.85 +/- 61.40 scan-point x ng. equivalent fluorescein/ml) resulted similar (peak value: p = 0.83; area: p = 0.61) to those of diabetic patients without retinopathy (peak value: mean 11.2 +/- 3.4 ng.eq/ml; area: 170.07 +/- 57.23 scan-pnt.ng.eq/ml). A statistically significant difference was found between diabetic patients without retinopathy and patients with stage 2, 3, 4 retinopathy. No statistically significant difference was found both for the peak value (p = 0.50) and for the area (p = 0.61) between stage 3 and stage 4 retinopathy. The sensitivity and specificity of corneal autofluorescence as a screening test for diabetic retinopathy were 82% and 62% for the peak value, 87% and 60% for the area; the positive predictive value for the presence of diabetic retinopathy was 65% for the peak and 63% for the area.
角膜自发荧光最近已被作为糖尿病患者视网膜病变严重程度的一个预测指标进行研究。我们测量了69例糖尿病患者的138只眼以及32例健康对照者的64只眼的角膜自发荧光。根据改良的艾利屋分类法（1期：无或轻度视网膜病变；2期：轻度背景性视网膜病变；3期：背景性视网膜病变；4期：（预）增殖性视网膜病变），将糖尿病患者按视网膜病变的严重程度进行细分。用扫描荧光光度计（Fluorotron Master，相干辐射公司，加利福尼亚州帕洛阿尔托）测量角膜自发荧光曲线的峰值和曲线下面积。健康对照者的角膜自发荧光值（峰值：平均11.03±3.77纳克当量荧光素/毫升；面积：平均163.85±�1.40扫描点×纳克当量荧光素/毫升）与无视网膜病变的糖尿病患者的值（峰值：平均11.2±3.4纳克当量/毫升；面积：170.07±57.23扫描点·纳克当量/毫升）相似（峰值：p = 0.83；面积：p = 0.61）。在无视网膜病变的糖尿病患者与患有2期、3期、4期视网膜病变的患者之间发现了统计学上的显著差异。在3期和4期视网膜病变之间，无论是峰值（p = 0.50）还是面积（p = 0.61）均未发现统计学上的显著差异。角膜自发荧光作为糖尿病视网膜病变筛查试验的敏感性和特异性，峰值分别为82%和62%，面积分别为87%和60%；糖尿病视网膜病变存在的阳性预测值，峰值为65%，面积为63%。
