Saini J S, Mittal S
Postgraduate Institute of Medical Education and Research, Chandigarh.
Indian J Ophthalmol. 1996 Dec;44(4):219-23.
Several alternative approaches to screen diabetics followed by referral of patients with retinopathy changes, are being investigated. The intent is to demonstrate usefulness of a cost effective, easy and valid screening test. We investigated in this report the efficacy of graded corneal sensitivity for screening presence of diabetic retinopathy. In 105 randomly chosen subjects with (70 subjects) and without (35 subjects) diabetes mellitus, corneal aesthesiometry and status of retinopathy was determined independently. Corneal sensitivity in subjects of diabetes mellitus without retinopathy (1.17 +/- 0.29 gm/mm2) was significantly different when compared to healthy controls (0.99 +/- 0.04 gm/mm2) (p < 0.01). Also corneal sensitivity in eyes with any type of retinopathy was significantly worse (1.94 +/- 1.33 gm/mm2) when compared to eyes without retinopathy. At a cut off value of 1.20 gm/mm2 the sensitivity and specificity of corneal hypoesthesia as a test to detect diabetic retinopathy was 86% and 74%, respectively. For detecting presence of proliferative diabetic retinopathy at a cut off value of 1.49 gm/mm2 the sensitivity and specificity were 89% and 80% respectively. These observations indicate that corneal hypoesthesia may be a reasonable indication of the presence of diabetic retinopathy and could be used to screen diabetic populations for retinopathy, after its validity is confirmed in larger studies.
目前正在研究几种替代方法，用于筛查糖尿病患者，然后将有视网膜病变改变的患者转诊，目的是证明一种具有成本效益、简便且有效的筛查测试的实用性。在本报告中，我们研究了分级角膜敏感性对筛查糖尿病性视网膜病变的有效性。在105名随机选择的受试者中，70名患有糖尿病，35名未患糖尿病，分别独立测定角膜感觉测量法和视网膜病变状况。无视网膜病变的糖尿病受试者的角膜敏感性（1.17±0.29克/平方毫米）与健康对照组（0.99±0.04克/平方毫米）相比有显著差异（p<0.01）。此外，与无视网膜病变的眼睛相比，任何类型视网膜病变的眼睛的角膜敏感性明显更差（1.94±1.33克/平方毫米）。在临界值为1.20克/平方毫米时，角膜感觉减退作为检测糖尿病性视网膜病变的测试的敏感性和特异性分别为86%和74%。在临界值为1.49克/平方毫米时，检测增殖性糖尿病性视网膜病变的敏感性和特异性分别为89%和80%。这些观察结果表明，角膜感觉减退可能是糖尿病性视网膜病变存在的合理指标，在更大规模的研究证实其有效性后，可用于筛查糖尿病患者的视网膜病变。
