Central Corneal Thickness Increase Due to Stromal Thickening With Diabetic Peripheral Neuropathy Severity.
Central Corneal Thickness Increase Due to Stromal Thickening With Diabetic Peripheral Neuropathy Severity.
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DOI：
10.1097/ico.0000000000001668
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发表时间：
2018-09
期刊：
影响因子：
2.8
通讯作者：
Shtein R
中科院分区：
文献类型：
--
作者：
Kumar N;Pop-Busui R;Musch DC;Reed DM;Momont AC;Hussain M;Raval N;Moroi SE;Shtein R
研究糖尿病周围神经病变（DPN）患者中央角膜厚度（CCT）与糖尿病严重程度的关系。在这项横断面研究中，对34名参与者进行了检查。通过临床检查、神经传导研究和定量感觉测试评估DPN状态。所有参与者都进行了全面的眼科检查，包括通过Goldmann压平眼压计测量的眼内压（IOP）。使用超声测厚法测量CCT，并使用角膜共焦显微镜评估角膜层的厚度。CCT与DPN的相关性采用方差分析进行检验。其中对照组9例，轻度DPN组16例，重度DPN组9例。与对照组相比，DPN组的CCT显著增加（P = 0.0003）。对照组的平均CCT为552.7 ± 29.2 μm，轻度DPN组为583.4 ± 25.0 μm，重度DPN组为613.3 ± 28.8 μm。此外，三个研究组之间的基质厚度存在显著差异（P = 0.045）。对照组间质平均厚度为439.5 ± 23.5 μm，轻度DPN组为478.9 ± 37.5 μm，重度DPN组为494.5 ± 39.1 μm。这项研究表明，由于基质厚度增加，CCT随着DPN严重程度的增加而增加。与DPN相关的CCT增加具有重要的临床意义，包括青光眼进展、圆锥角膜易感性和IOP评估，在评估糖尿病患者时应考虑在内。
To investigate the relationship between central corneal thickness (CCT) and diabetes disease severity among patients with diabetic peripheral neuropathy (DPN) compared to controls. In this cross-sectional study, 34 participants were examined. DPN status was assessed by clinical examination, nerve conduction studies and quantitative sensory testing. All participants underwent a comprehensive eye examination that included intraocular pressure (IOP) measured by Goldmann applanation tonometry. CCT was measured using ultrasound pachymetry, and the thickness of the corneal layers was assessed using corneal confocal microscopy. Association of CCT and DPN was examined using analysis of variance. Among the 34 participants, there were 9 controls, 16 cases with mild DPN and 9 cases with severe DPN. CCT was significantly increased in the DPN groups compared to controls (P = 0.0003). Mean CCT among controls was 552.7 ± 29.2 μm, compared to 583.4 ± 25.0 μm in the mild DPN group and 613.3 ± 28.8 μm in the severe DPN group. Additionally, the stromal thickness differed significantly between the three study groups (P = 0.045). The mean stromal thickness among controls was 439.5 ± 23.5 μm compared to 478.9 ± 37.5 μm in the mild DPN group and 494.5 ± 39.1 μm in the severe DPN group. This study demonstrates that CCT increases with DPN severity due to an increase in stromal thickness. The CCT increase associated with DPN has important clinical implications including glaucoma progression, keratoconus susceptibility and IOP assessment, and should be accounted for when evaluating patients with diabetes.