Diabetic Retinopathy and Changes in Corneal Nerve Fibers Assessed by Confocal Microscopy

Czech version

Authors: M. Česká Burdová ¹; T. Lainová Vrabcová ¹; D. Dotřelová ¹; G. Mahelková ^1,2
Authors‘ workplace: Oční klinika dětí a dospělých 2. LF UK a FN Motol, Praha ¹; Ústav fyziologie, 2. LF UK v Praze ²
Published in: Cesk Slov Neurol N 2017; 80/113(1): 59-65
Category: Original Paper

Overview

Aim:
The aim of the study was to test possible correlation between corneal sub-basal nerve plexus changes and the grade of diabetic retinopathy (DR).

Methods:
A total of 38 patients with type 1 diabetes, divided into three groups according to the grade of diabetic retinopathy, and 12 age-matched healthy subjects underwent corneal confocal microscopy. Corneal main nerve fiber density (CNFD), total corneal nerve fiber density (t-CNFD), nerve fiber length (CNFL) and nerve tortuosity (CNFT) were evaluated.

Results:
CNFD was lower in patients without DR, with mild grade DR, and with advanced grade DR than in healthy subjects (p < 0.0001, p = 0.004 and p < 0.0001, respectively). There was also lower CNFD in patients with advanced grade DR than with mild grade DR (p = 0.036). T-CNFD was lower in patients without DR and advanced grade DR than in healthy subjects (p = 0.024 and p < 0.0001, respectively). CNFL was lower in patients without DR and advanced grade DR than in healthy subjects (p = 0.028). CNFT was higher in patients with advanced grade DR than in healthy subjects and patients without DR (p < 0.0001; p = 0.001).

Conclusion:
We demonstrated changes in corneal sub-basal nerve fiber count in all diabetic patient groups, with or without DR. The changes were more pronounced in patients without DR than with mild grade DR. The study suggests no direct correlation between progression of corneal nerve fiber changes and changes in DR.

Key words:
confocal microscopy – cornea – small fiber neuropathy – diabetes mellitus type 1 – diabetic retinopathy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

糖尿病性视网膜病和神经纤维的改变

额定角膜共聚焦显微镜

摘要

目标：

研究I型糖尿病患视网膜病患患者角膜神经丛变化与糖尿病程度的相关性。

方法：

根据角膜共聚焦显微镜检查，根据糖尿病性视网膜病的程度（DR）将38例患者分为三组，以及12名健康志愿者。评价神经纤维和芯毛（CNFD，CNFD）的数量，总长度（CNFL）和扭曲（CNFT）。

结果：

轻度和重度DR患者的CNFD比健康人降低（P <0.0001，P = 0.004，P <0.0001）。 CNFD在较低组比DR轻微程度（P = 0.036），重度。 T-CNFD在较低没有DR和DR严重组较健康者（P = 0.024，P <0.0001）。 CNFL较健康无DR和DR组中重度低受试者（P = 0.007，P <0.0001），重症患者有轻步比较DR（p值= 0.028）。 CNFT是比较健康有严重的DR组高个人和无DR组（p <0.0001; P = 0.001）。

结论：

我们证明角膜受损神经纤维的DM患者所有组

1.变化更为明显在患者无DR比DR的程度轻微。这表明角膜神经纤维受损程度和DR的程度不平行。

关键词：

共聚焦显微镜 - 角膜 - 糖尿病第一类型 - 糖尿病视网膜病变

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