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通过广域Mosaic分析2型糖尿病的角膜神经纤维密度降低

Lagali, N.S., Allgeier, S., Guimar?es, P., et al.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第14期

摘要

摘要:目的:旨在探讨广域深度校正镶嵌图像的角膜亚基神经丛(SBP)参数是否与2型糖尿病相关。方法:通过激光扫描体内共焦显微术(IVCM)对82名受试者眼进行163次镶嵌图像分析。受试者年龄相同,没有(43人)或有2型糖尿病(39人)。定量分析角膜神经纤维长度密度(mCNFL)和角膜神经纤维长度密度(wCNFL)与糖尿病和持续时间(短期<10年,持续时间≥10年)的关系。结果:69.1±1.2岁受试者的mosaics图像平均大小为6mm 2,在2型糖尿病中mCNFL相对于非糖尿病受试者减少(13.1±4.215.0±3.2mm / mm 2P = 0.018)。相对于非糖尿病受试者,短期糖尿病患者(14.0±4.0 mm / mm23.2±3.9岁)和长期糖尿病患者(12.7±4.2 mm / mm215.4±4.2; ANOVA P = 0.023)的mCNFL也有下降。mCNFL较低与糖尿病(P = 0.032)和血红蛋白A1cHbA1c)水平升高(P = 0.047)相关。相比之下,wCNFL不受糖尿病或HbA1c的影响(P> 0.05)。全眼SBP模式显示长期糖尿病患者螺旋区外侧次级神经纤维支明显变性。结论:广域镶嵌图像为mCNFLwCNFL提供了参考值,并显示随着2型糖尿病持续时间增加,SBP逐渐变性。

Purpose:To determine if corneal subbasal nerve plexus (SBP) parameters derived from wide-area depth-corrected mosaic images are associated with type 2 diabetes.Methods:One hundred sixty-three mosaics were produced from eyes of 82 subjects by laser-scanning in vivo confocal microscopy (IVCM). Subjects were of the same age, without (43 subjects) or with type 2 diabetes (39 subjects). Mosaic corneal nerve fiber length density (mCNFL) and apical whorl corneal nerve fiber length density (wCNFL) were quantified and related to the presence and duration of diabetes (short duration < 10 years and long duration 10 years).Results:In mosaics with a mean size of 6 mm2 in subjects aged 69.1 ± 1.2 years, mCNFL in type 2 diabetes was reduced relative to nondiabetic subjects (13.1 ± 4.2 vs. 15.0 ± 3.2 mm/mm2, P = 0.018). Also reduced relative to nondiabetic subjects was mCNFL in both short-duration (14.0 ± 4.0 mm/mm2, 3.2 ± 3.9 years since diagnosis) and long-duration diabetes (12.7 ± 4.2 mm/mm2, 15.4 ± 4.2 years since diagnosis; ANOVA P = 0.023). Lower mCNFL was associated with presence of diabetes (P = 0.032) and increased hemoglobin A1c (HbA1c) levels (P = 0.047). By contrast, wCNFL was unaffected by diabetes or HbA1c (P > 0.05). Global SBP patterns revealed marked degeneration of secondary nerve fiber branches outside the whorl region in long-duration diabetes.Conclusions:Wide-area mosaic images provide reference values for mCNFL and wCNFL and reveal a progressive degeneration of the SBP with increasing duration of type 2 diabetes.


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