Corneal hydration control in diabetes mellitus.
Corneal hydration control in diabetes mellitus.
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DOI：
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发表时间：
1995-03
影响因子：
4.4
通讯作者：
B. Weston;William M. Bourne;K. Polse;David O. Hodge
中科院分区：
文献类型：
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作者：
B. Weston;William M. Bourne;K. Polse;David O. Hodge
目的 评估糖尿病对角膜结构和功能的影响。方法 作者测量了 20 名患有非增殖性视网膜病变的糖尿病患者和 21 名年龄匹配的对照受试者，在佩戴缺氧隐形眼镜 2 小时后 7.5 小时内，内皮对荧光素的通透性和角膜消肿情况。还拍摄了中央角膜内皮照片。通过非线性回归技术估计角膜消肿率（以每小时恢复百分比（PRPH）表示）和睁眼稳态（OESS）厚度。结果 糖尿病患者的 OESS 厚度大于对照组（562 +/- 35 微米 vs 539 +/- 24 微米，P = 0.02）。缺氧期间，与对照组相比，糖尿病患者角膜肿胀较少（7.7%+/-1.8% vs 9.9%+/-1.6%，P < 0.001），内皮通透性较低（3.55+/-0.83 x 10(-4) cm/min vs 4.14 +/- 0.68 x 10(-4) cm/min，P = 0.02）。然而，在摘除隐形眼镜后，在含氧量正常的情况下，糖尿病角膜和对照角膜具有相似的消肿率和渗透性。糖尿病患者的角膜自发荧光增加（8.1 +/- 3.1 与 6.0 +/- 1.9 ng/ml 荧光素当量，P = .005）。两组内皮细胞形态相似。然而，在糖尿病组中，与轻度非增殖性视网膜病变患者相比，患有中度非增殖性视网膜病变的患者具有更大的细胞面积变异系数和更小的六角形细胞百分比。结论 尽管糖尿病患者的角膜比对照角膜更厚且自发荧光更强，但在缺氧期间，它们的肿胀程度较小，并且内皮通透性降低。然而，在含氧量正常期间，内皮通透性或消肿率没有发现差异。糖尿病对内皮细胞形态特征的影响似乎与糖尿病的严重程度有关。
PURPOSE To assess the effects of diabetes mellitus on corneal structure and function. METHODS The authors measured endothelial permeability to fluorescein and corneal deswelling for 7.5 hours after 2 hours of hypoxic contact lens wear in 20 patients with diabetes who had nonproliferative retinopathy and 21 age-matched control subjects. Central corneal endothelial photographs were also taken. Corneal deswelling rates, expressed as percent recovery per hour (PRPH), and open eye steady state (OESS) thickness were estimated by nonlinear regression techniques. RESULTS The OESS thickness was greater in patients with diabetes than in controls (562 +/- 35 microns versus 539 +/- 24 microns, P = 0.02). During hypoxia, the diabetic corneas swelled less (7.7% +/- 1.8% versus 9.9% +/- 1.6%, P < 0.001) and had less endothelial permeability (3.55 +/- 0.83 x 10(-4) cm/min versus 4.14 +/- 0.68 x 10(-4) cm/min, P = 0.02) than the controls. During normoxia after contact lens removal, however, diabetic and control corneas had similar deswelling rates and permeabilities. Corneal autofluorescence was increased in the patients with diabetes (8.1 +/- 3.1 versus 6.0 +/- 1.9 ng/ml fluorescein equivalents, P = .005). The endothelial cells of the two groups were morphologically similar. Within the group with diabetes, however, those with moderate nonproliferative retinopathy had larger coefficients of variation of cell area and smaller percentages of hexagonal cells than those with mild nonproliferative retinopathy. CONCLUSIONS Although the diabetic corneas were thicker and more autofluorescent than control corneas, during hypoxia they swelled less and had decreased endothelial permeability. During normoxia, however, no difference was found in endothelial permeability or deswelling rate. The effects of diabetes on endothelial cell morphologic features appear to be related to the severity of the diabetes.