Fujishima H, Shimazaki J, Yagi Y, Tsubota K
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Cornea. 1996 Jul;15(4):368-75. doi: 10.1097/00003226-199607000-00006.
The mechanism in the pathogenesis of diabetic corneal disease is unclear, but aldose reductase may be involved in the corneal disease. We studied the effects of an aldose reductase inhibitor (ARI) on the ocular surface of diabetic patients. Fourteen aphakic or pseudophakic patients with diabetes were treated with orally administered ONO-2235 (150 mg/day). Corneal sensation, vital staining of ocular surface, and tear production were examined before and 3 months after the administration. After a 3-month period of oral ARI, corneal sensation recovered significantly (from 4.1 +/- 4.8 to 3.0 +/- 3.1 g/mm2; p = 0.015), with parallel improvements in rose bengal and fluorescein staining scores (p < 0.05). Tear break-up time had also improved (p = 0.003). Results of Schirmer's test (p = 0.03) and the cotton-thread test (p = 0.0001) showed significant improvement in tear production. Improvement in the dynamics of tear production may be due to an improvement in corneal sensitivity. An oral ARI can improve corneal epithelial changes caused by diabetes, probably through recovery of corneal sensation and tear production.
糖尿病角膜病变发病机制尚不清楚，但醛糖还原酶可能参与其中。我们研究了醛糖还原酶抑制剂（ARI）对糖尿病患者眼表的影响。14例无晶状体或人工晶状体植入的糖尿病患者口服ONO - 2235（150毫克/天）进行治疗。给药前及给药3个月后检查角膜感觉、眼表活体染色及泪液分泌情况。口服ARI 3个月后，角膜感觉显著恢复（从4.1±4.8降至3.0±3.1克/平方毫米；p = 0.015），同时孟加拉玫瑰红和荧光素染色评分也有相应改善（p < 0.05）。泪膜破裂时间也有所改善（p = 0.003）。泪液分泌试验（p = 0.03）和棉线试验（p = 0.0001）结果显示泪液分泌有显著改善。泪液分泌动态的改善可能归因于角膜敏感性的提高。口服ARI可能通过恢复角膜感觉和泪液分泌，改善糖尿病引起的角膜上皮变化。
