临床眼科杂志2025，Vol.33Issue(2)：133-138,6.DOI:10.3969/j.issn.1006-8422.2025.02.008
角膜激光共焦显微镜在糖尿病角膜病变中的应用
Application of corneal confocal microscopy in diabetic keratopathy
摘要
Abstract
Objective To investigate the changes of corneal cells and subepithelial nerve fibers in patients with diabetic retinopathy(DR)at different stages by corneal confocal microscopy(CCM),so as to facilitate clinical diagnosis and treatment.Methods The prospective case-control study.A total of 76 patients(76 eyes)who were admitted to the dia-betic fundus clinic of our hospital from December 2022 to October 2023 were enrolled and divided into 34 patients with no fundus changes(DNR)(34 eyes)were selected as NDR group,40 patients with non-proliferative diabetic retinopathy(NPDR)(40 eyes)were selected as NPDR group,and 36 patients with proliferative diabetic retinopathy(PDR)(36 eyes)were selected as PDR group according to the international clinical clinical retinopathy staging criteria.During the same pe-riod,30 patients with cataract(without a history of diabetes)were treated as the control group(30 eyes)were selected as control group,and all four groups were detected by the same operator using CCM,and the differences in corneal epithelial basal cells,stromal cells,endothelial cells,langerhans cell density,subepithelial nerve fiber length(NFL),nerve fiber density(NFD),nerve fiber branch density(NFB)and nerve fiber curvature(NT)were compared among the four groups.Results The densities of corneal epithelial basal cells in the control group,NDR group,NPDR group,and PDR group were(7 256±644),(6 550±699),(6 417±457),and(5 698±434),respectively,and the difference between the four groups was statistically significant(F=42.53,P<0.01).The endothelial cell densities in the control group,NDR group,NPDR group,and PDR group were(2 930±242),(2 871±290),(2 768±319),and(2 681±345)cells/mm2,respectively,and the cell densities of langerhans cells were(1.4±0.8),(2.9±0.7),(5.1±1.8),and(7.9±1.8),respectively,and there were statistically significant differences between the four groups(F=22.36,182.13,P<0.05).There were statistically sig-nificant differences in the density of shallow,medium and deep stromal cells between the control group,NDR group,NPDR group and PDR group(F=44.25,47.83,34.22,P<0.05).The NFL of the control group,NDR group,NPDR group and PDR group were(18.81±1.65),(16.35±0.80),(13.29±1.12)and(7.79±0.84)mm/mm2,respectively,and the dif-ference between the four groups was statistically significant(F=595.23,P<0.01).There were statistically significant dif-ferences in NFD,NFB and NT groups among the control group,NDR group,NPDR group and PDR group(F=90.02,88.95,67.59,P<0.05).Conclusions With the progression of diabetic retinopathy,the density of corneal epithelial basal cells,stromal cells,and endothelial cells decreased,and the number of langerhans cells increased.The NFL,NFD,and NFB all decreased,and NT increased.CCM can effectively observe the changes of corneal cells and subepithelial nerve fibers in diabetic patients,and provide guidance for the prevention,diagnosis and treatment of diabetic corneal lesions.关键词
角膜激光共焦显微镜/糖尿病视网膜病变/糖尿病角膜病变/神经纤维/细胞Key words
Corneal confocal microscopy/Diabetic retinopathy/Diabetic keratopathy/Nerve fibers/Cell引用本文复制引用
赵芳,徐曼,夏桂媚,何玉枚,王丹,覃兰芳,杨兰..角膜激光共焦显微镜在糖尿病角膜病变中的应用[J].临床眼科杂志,2025,33(2):133-138,6.基金项目
爱尔眼科医院集团科研基金项目(AF2214D01) （AF2214D01）
