Larsson L I, Bourne W M, Pach J M, Brubaker R F
Department of Ophthalmology, Mayo Clinic, Rochester, Minn., USA.
Arch Ophthalmol. 1996 Jan;114(1):9-14. doi: 10.1001/archopht.1996.01100130007001.
To measure and compare corneal endothelial morphologic characteristics and function in subjects with diabetes mellitus types I and II.
Forty-nine patients with diabetes mellitus type I and 60 patients with diabetes mellitus type II were recruited from the active practice of the Mayo Clinic, Rochester, Minn. Thirty-one normal subjects, divided by age into two overlapping groups of 20 each, served as controls. Corneal endothelial permeability and corneal autofluorescence were measured by fluorophotometry. Central corneal endothelial photographs were taken with a wide-field specular microscope, which also measured the corneal thickness.
Neither the type I nor the type II diabetics differed from their controls in endothelial permeability and endothelial cell density. The type I diabetics had polymegethism, pleomorphism, increased corneal thickness, and increased corneal autofluorescence compared with their controls. Similar measured values were found in the type II diabetics, but they did not differ significantly from those of their age-matched controls. The type II diabetics were older than the type I diabetics, and the older control group showed changes similar to those seen in the diabetics; these changes were presumably associated with aging. The severity of retinopathy was significantly correlated only with corneal autofluorescence.
The corneas of patients with type I diabetes mellitus exhibit abnormalities in endothelial cell morphologic characteristics and corneal autofluorescence. The changes resemble those that occur with aging in normal subjects, making them difficult to discern as abnormal in type II diabetics, who are usually older. We found no abnormalities in endothelial permeability in either type I or type II diabetics.
测量并比较Ⅰ型和Ⅱ型糖尿病患者的角膜内皮形态特征及功能。
从明尼苏达州罗切斯特市梅奥诊所的门诊患者中招募了49例Ⅰ型糖尿病患者和60例Ⅱ型糖尿病患者。31名正常受试者按年龄分为两组，每组20人，作为对照组。采用荧光光度法测量角膜内皮通透性和角膜自发荧光。用宽视野镜面显微镜拍摄中央角膜内皮照片，并测量角膜厚度。
Ⅰ型和Ⅱ型糖尿病患者在内皮通透性和内皮细胞密度方面与对照组相比均无差异。与对照组相比，Ⅰ型糖尿病患者存在大小不均、形态各异、角膜厚度增加以及角膜自发荧光增强的情况。Ⅱ型糖尿病患者也有类似的测量值，但与年龄匹配的对照组相比无显著差异。Ⅱ型糖尿病患者比Ⅰ型糖尿病患者年龄大，年龄较大的对照组显示出与糖尿病患者类似的变化；这些变化可能与衰老有关。视网膜病变的严重程度仅与角膜自发荧光显著相关。
Ⅰ型糖尿病患者的角膜内皮细胞形态特征和角膜自发荧光存在异常。这些变化与正常受试者衰老时出现的变化相似，使得在通常年龄较大的Ⅱ型糖尿病患者中难以辨别其异常。我们发现Ⅰ型和Ⅱ型糖尿病患者的内皮通透性均无异常。
