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2017, Number 1

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Rev Acta Médica 2017; 18 (1)

Study of the sub-basal epithelial nerve plexus in diabetic patients thorough corneal confocal microscopy

Ponce TY, Mokey CMO, Yang T, Espinosa GA

Language: Spanish
References: 22
Page:
PDF size: 250.92 Kb.


ABSTRACT

Objective: To evaluate the morphological changes of the sub-basal epithelial corneal nerve plexus in eyes of diabetic patients and their relation with the severity of diabetic retinopathy.
Method: A descriptive cross-sectional study was carried out, including 39 eyes from 21 patients diagnosed with type 2 diabetes mellitus. Group 1 included patients without diabetic retinopathy; Group 2, non-proliferative diabetic retinopathy; Group 3, Proliferative diabetic retinopathy; and the Control group, with 38 eyes of 19 healthy subjects. All were submitted to the confocal microscopy examination for the study of corneal diabetic neuropathy by analyzing 4 parameters: number of fibers, beading grading, branching pattern and fiber tortuosity.
Results: The numbers of fibers and beading grading, and the branching pattern decreased significantly in diabetic patients compared to the control group (p ‹ 0.001, p ‹ 0.001 and p ‹ 0.001, respectively). The fiber tortuosity was found to be increased in diabetic patients compared to the control group. It was observed that as the diabetic retinopathy progresses there is a decrease in the number of fibers and beading grading.
Conclusions: There are morphological changes of the sub-basal epithelial nerve plexus in the eyes of diabetic patients with respect to healthy subjects. These alterations become more severe as the severity of diabetic retinopathy increases.


REFERENCES

  1. Muller LJ, Vrensen GF, Pels L, Cardozo BN, Willekens B.. Architecture of human corneal nerves. Invest Ophthalmol Vis Sci. 1997;38:985-94.

  2. Cruzat A, Pavan-Langston D, Hamrah P. In Vivo Confocal Microscopy of Corneal Nerves: Analysis and Clinical Correlation. Semin Ophthalmol. 2010;25(5-6):171-7.

  3. Muller LJ, Pels L, Vrensen GF. Ultrastructural organization of human corneal nerves. Invest Ophthalmol Vis Sci. 1996;37:476-88.

  4. Oliveira-Soto L, Efron N. Morphology of corneal nerves using confocal microscopy. Cornea. 2001;20:374-84.

  5. Muller LJ, Marfurt CF, Kruse F, Tervo TM. Corneal nerves: structure, contents and function. Exp Eye Res. 2003;76:521-42.

  6. Patel DV, McGhee CNJ. In vivo confocal microscopy of human corneal nerves in health, in ocular and systemic disease, and following corneal surgery: a review. Br J Ophthalmol. 2009;93:853-60.

  7. Patel DV, McGhee CNJ. Mapping of the Normal Human Corneal Sub-Basal Nerve Plexus by In Vivo Laser Scanning Confocal Microscopy. Invest Ophthalmol Vis Sci. 2005;46:12.

  8. Guthoff RF, Zhivov A, Stachs O. In vivo confocal microscopy, an inner vision of the cornea - a major review. Clin and Experiment Ophthalmol. 2009;37:100-17.

  9. Erie JC, McLaren JW, Patel SV. Confocal Microscopy in Ophthalmology. Am J Ophthal. 2009;148:639-46.

  10. Midena E, Cortese M, Mioto S, Cavarzeran F, Gambato C, Ghirlando A. Confocal Microscopy of corneal sub-basal nerve plexus: a cuantitative y cualitative analysis in health and patologic eyes. J Refract Surg. 2009 Jan;25 (1 suppl):S125-30.

  11. Shaw JE, Sicree R. (2008). Epidemiology of type 2 diabetes. In: Feinglos MN, Bethel MA, eds. Contemporary Endocrinology: Type 2 Diabetes Mellitus: An Evidence- Based Approach to Practical Management. Totowa, NJ: Humana Press; 1-16.

  12. Diabetes statistics. Alexandria VA: American Diabetes Association. Available from: http://www.diabetes.org/diabetes-basics/diabetes-satatistics Consultado: 17 de enero de 2016.

  13. Nitoda E, Kallinikos P, Pallikaris A, Moschandrea J, Amoiridis G, Ganotakis ES, et al. Correlation of diabetic retinopathy and corneal neuropathy using confocal microscopy. Curr Eye Res. 2012 Oct;37(10):898-906.

  14. Midena E, Brugin E, Ghirlando A, Sommavilla M, Avogaro AJ. Corneal diabetic neuropathy: a confocal microscopy study. Refract Surg. 2006 Nov;22(9 Suppl):S1047- 52.

  15. Early Treatment Diabetic Retinopathy Study Research Group: Fundus photographic risk factors for progression of diabetic retinopathy, ETDRS report no 12. Ophthalmology. 1991;98:757-65.

  16. Erie JC, McLaren JW, Hodge DO, Bourne WM. The effect of age on the corneal subbasal nerve plexus. Cornea. 2005;6:705-9.

  17. Malik RA, Kallinikos P, Abbott CA, van Schie CH, Morgan P, Efron N, et al. Corneal confocal microscopy: a non-invasive surrogate of nerve fibre damage and repair in diabetic patients. Diabetologia. 2003;46:683-8.

  18. Tavakoli M, Quattrini C, Abbott C, Kallinikos P, Marshall A, Finnigan J, et al. Morgan P, Efron N, Boulton AJ, Malik RA. Corneal confocal microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic neuropathy. Diabetes Care. 2010 Aug;33(8):1792-7.

  19. Quattrini C, Tavakoli M, Jeziorska M, Kallinikos P, Tesfaye S, Finnigan J, et al. Surrogate markers of small fiber damage in human diabetic neuropathy. Diabetes. 2007;56:2148-54.

  20. Kallinikos P, Berhanu M, O’Donnell C, Boulton AJ, Efron N, Malik RA. Corneal nerve tortuosity in diabetic patients with neuropathy. Invest Ophthalmol Vis Sci. 2004;45:418-22.

  21. Rosemberg ME, Tervo TMT, Immonen IJ, Muller LJ, Gronhagen-Riska C, Vesaluoma MH. Corneal structure and sensitivity in tipo I diabetes mellitus. Invest Ophthalmol Vis Sci. 2000;41:2915-21.

  22. Messmer EM, Schmid-Tannwald C, Zapp D, Kampik A. In vivo confocal microscopy of corneal small fiber damage in diabetes mellitus. Graefes Arch Clin Exp Ophthalmol. 2010;248:1307-12.




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