CORNEAL ENDOTHELIAL CHANGES IN TYPE-I AND TYPE-II DIABETES-MELLITUS

CORNEAL ENDOTHELIAL CHANGES IN TYPE-I AND TYPE-II DIABETES-MELLITUS
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DOI:
10.1016/0002-9394(84)90120-x
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发表时间:
1984-01-01
影响因子:
4.2
通讯作者:
SCHULTZ, KJ
SCHULTZ, KJ
中科院分区:
医学1区
文献类型:
--
作者:
SCHULTZ, RO;MATSUDA, M;SCHULTZ, KJ

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对25例患有II型(成人发病)糖尿病10年的患者的角膜(46例)进行了镜面显微镜检查,并对单个内皮细胞进行了形态定量分析。对21例年龄匹配的非糖尿病受试者的34个角膜进行了检查以作比较。对17例I型(幼年型)糖尿病患者的31个角膜也进行了检查,并与23名年龄匹配的正常志愿者的41个角膜进行了比较。与年龄匹配的非糖尿病人群相比,II型糖尿病患者的角膜内皮细胞在细胞密度上没有差异,但显示出显著更高的变异系数,六角形细胞百分比的减少,以及较低的图形系数。I型糖尿病产生了类似的细胞变化;这些变化发生在前几十年。在I型糖尿病中检测到的细胞丢失率明显更高,导致在第4和第50年细胞密度显著下降。糖尿病血管内皮细胞形态异常。观察到的解剖学变化导致更不稳定和更脆弱的细胞层,这可能解释了手术创伤后糖尿病角膜的一些持续临床变化。
Corneas (46) from 25 patients who had had type II (adult-onset) diabetes for 10 yr were examined by specular microscopy with quantitative morphometric analyses of individual endothelial cells. Corneas (34) from 21 age-matched nondiabetic subjects were examined for comparison. Corneas (31) from 17 patients with type I (juvenile-onset) diabetes were also examined and compared to 41 corneas from 23 age-matched normal volunteers. The corneal endothelium in type II diabetes showed no difference in cell density but demonstrated a significantly higher coefficient of variation, a decrease in the percentage of hexagonal cells, and a low figure coefficient compared to an age-matched nondiabetic population. Type I diabetes produced similar cell changes; these changes occurred in the earlier decades. A significantly higher rate of cell loss was detected in type I diabetes, resulting in a significant decrease in cell density in the 4th and 5th decades. The diabetic endothelium is morphologically abnormal. The observed anatomic changes result in a less stable and more vulnerable cell layer, possibly explaining some of the persistent clinical changes in the diabetic cornea after surgical trauma.