The effect of the duration of diabetes on dry eye and corneal nerves
The effect of the duration of diabetes on dry eye and corneal nerves
复制标题
糖尿病病程对干眼和角膜神经的影响
DOI：
10.1016/j.clae.2019.02.011
复制
发表时间：
2019-08-01
影响因子：
3.2
通讯作者：
Zhao, Shaozhen
中科院分区：
文献类型：
--
作者：
Lyu, Ying;Zeng, Xiaoyu;Zhao, Shaozhen
目的：目的探讨2型糖尿病（DM）病程与眼表的关系，以及为什么有些DM病程较长的人无症状，而有些DM病程较短的人眼睛疼痛或不适。方法：对87例不同病程的DM患者的87只眼和49例非DM患者的49只眼进行Schirmer I试验、泪膜破裂时间、荧光素钠染色和泪液半月板高度（TMH）测量，并完成眼干燥的标准化患者评估（SPEED）问卷。角膜结构和功能进行了评估，在体内共焦角膜显微镜和角膜敏感性触觉仪。角膜神经纤维长度和下轮长度（IWL）作为神经结构的指标进行评估。两组之间的年龄和性别相匹配。结果：与非糖尿病组相比，糖尿病组的SPEED评分明显增高（p = 0.013），角膜敏感性和IWL明显降低（p < 0.001）。糖尿病病程> 10年组与非糖尿病组（对照组）之间的Schirmer I试验、角膜敏感性和IWL差异显著（分别为p = 0.021，p <0.001，p < 0.001）。DM > 10年组的Schirmer I试验和IWL显著低于DM = 10年组（分别为p = 0.023，p < 0.001）。无论糖尿病状态如何，角膜敏感性与IWL正相关。结论：糖尿病持续时间较长的人的SPEED评分较低和无症状感觉可能是由IWL降低和敏感性降低来解释的。
Purpose: To investigate the relationship between the duration of type 2 diabetes mellitus (DM) and the ocular surface, and to address the question of why some people with lengthy DM duration are asymptomatic, whereas some people with shorter DM duration have pain or discomfort in their eyes.Methods: Eighty-seven eyes of 87 subjects with different durations of DM and 49 eyes of 49 subjects without DM underwent Schirmer I test, tear film break-up time, sodium fluorescein staining and tear meniscus height (TMH) measurement, and completed the Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. Corneal structure and function were assessed with in vivo confocal corneal microscopy and with a corneal sensitivity esthesiometer. Both corneal nerve fiber length and inferior whorl length (IWL) were assessed as indices for neural structure. Age and gender were matched between groups. HbA1c levels > 7.8% and proliferative diabetic retinopathy were exclusion criteria.Results: In the DM group, compared with the non-DM group, the SPEED score was significantly higher (p = 0.013), and corneal sensitivity and IWL were lower (p < 0.001). Schirmer I test, corneal sensitivity and IWL differed significantly between the group with DM duration > 10 years and the non-DM (control) group (p = 0.021, p < 0.001, p < 0.001, respectively). Schirmer I test and IWL were significantly lower in the group with DM > 10 years than in the group with DM = 10 years (p = 0.023, p < 0.001, respectively). Corneal sensitivity was positively correlated with IWL regardless of diabetes status.Conclusions: The lower SPEED score and asymptomatic feeling in people with a longer DM duration may be explained by the decreased IWL and reduced sensitivity.