Clinical Research
Year 2023,
Volume: 6 Issue: 3, 429 - 433, 21.10.2023
Abstract
Amaç: İn vivo konfokal mikroskopi (IVKM), periferik sinir sisteminin küçük lifleri olan subbazal kornea sinir liflerini değerlendirmek için hızlı, invaziv olmayan bir yöntemdir. Kornea sinir lifi değişiklikleri diyabetik periferik nöropatinin bir belirteci olabilir. Bu çalışmanın amacı IVKM yöntemini kullanarak diyabetes mellitus (DM) tanısı olan hastalardaki olası korneal sinir lifi değişikliklerini incelemektir.
Yöntem: Tip 2 DM tanılı hastaların kornea innervasyon paternini İVKM kullanarak inceledik. DM hastaları ile kontrol grubunun korneal parametreleri karşılaştırıldı. DM hastalarının hemoglobin A1c (HbA1c) değerleri ve hastalık süreleri kayıt edildi ve korneal parametreler ile korelasyonuna bakıldı.
Bulgular: Yaşları 57 ± 2.0 olan toplam 31 DM hastası ve yaşları eşleştirilmiş (55 ± 3.8 yıl) 30 kontrol grubu değerlendirildi. Korneal epitel sayısı DM grubu ile kontrol grubunda benzerdi. Korneal subbazal pleksus (SBP) yoğunluğu DM grubunda kontrol grubuna kıyasla anlamlı düşüktü (p= 0,001). SBP gövde yoğunluğu diyabetik grupta istatistiksel anlamlı azdı (p= 0,038). SBP dal yoğunluğu diyabetik grupta, kontrol grubuna kıyasla düşüktü (p= 0,095).
Sonuç: Konfokal mikroskopi, in vivo olarak kornea sinir liflerindeki değişiklikleri göstermek için değerli bir araçtır. Diyabetik sinir lifi hasarını daha erken gösterme yeteneğine sahip olabilir.
References
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- Alam U, Ponirakis G, Asghar O, et al. Corneal confocal microscopy identifies people with type 1 diabetes with more rapid corneal nerve fibre loss and progression of neuropathy. J Clin Med. 2022;11(8):2249. doi:10.3390/jcm11082249
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- Bitirgen G, Ozkagnici A, Malik RA, Kerimoglu H. Corneal nerve fibre damage precedes diabetic retinopathy in patients with type 2 diabetes mellitus. Diabet Med. 2014;31(4):431-438. doi:10.1111/dme.12324
Year 2023,
Volume: 6 Issue: 3, 429 - 433, 21.10.2023
Abstract
References
- Petropoulos IN, Ponirakis G, Ferdousi M, et al. Corneal confocal microscopy: a biomarker for diabetic peripheral neuropathy. Clin Ther. 2021;43(9):1457-1475. doi:10.1016/j.clinthera.2021.04.003
- Celiker H, Erekul G, Turhan SA, et al. Early detection of neuropathy in patients with type 2 diabetes with or without microalbuminuria in the absence of peripheral neuropathy and retinopathy. J Fr Ophtalmol. 2021;44(4):485-493. doi:10.1016/j.jfo.2020.09.027
- Liau YJ, Lin SF, Lee IT. Scores of peripheral neuropathic pain predicting long-term mortality in patients with type 2 diabetes: A retrospective cohort study. Front Endocrinol (Lausanne). 2022;13:969149. doi:10.3389/fendo.2022.969149
- Tavakoli M, Kallinikos PA, Efron N, Boulton AJ, Malik RA. Corneal sensitivity is reduced and relates to the severity of neuropathy in patients with diabetes. Diabetes Care. 2007;30(7):1895-1897. doi:10.2337/dc07-0175
- Sumner CJ, Sheth S, Griffin JW, Cornblath DR, Polydefkis M. The spectrum of neuropathy in diabetes and impaired glucose tolerance. Neurology. 2003;60(1):108-111. doi:10.1212/wnl.60.1.108
- Tavakoli M, Petropoulos IN, Malik RA. Assessing corneal nerve structure and function in diabetic neuropathy. Clin Exp Optom. 2012;95(3):338-347. doi:10.1111/j.1444-0938.2012.00743.x
- Ziegler D, Papanas N, Zhivov A, et al. Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes. Diabetes. 2014;63(7):2454-2463. doi:10.2337/db13-1819
- Smith AG, Kim G, Porzio M, et al. Corneal confocal microscopy is efficient, well-tolerated, and reproducible. J Peripher Nerv Syst. 2013;18(1):54-58. doi:10.1111/jns5.12008
- Alam U, Ponirakis G, Asghar O, et al. Corneal confocal microscopy identifies people with type 1 diabetes with more rapid corneal nerve fibre loss and progression of neuropathy. J Clin Med. 2022;11(8):2249. doi:10.3390/jcm11082249
- Breiner A, Lovblom LE, Perkins BA, Bril V. Does the prevailing hypothesis that small-fiber dysfunction precedes large-fiber dysfunction apply to type 1 diabetic patients? Diabetes Care. 2014;37(5):1418-1424. doi:10.2337/dc13-2005
- Divisova S, Vlckova E, Hnojcikova M, et al. Prediabetes/early diabetes-associated neuropathy predominantly involves sensory small fibres. J Peripher Nerv Syst. 2012;17(3):341-350. doi:10.1111/j.1529-8027.2012.00420.x
- Løseth S, Stålberg E, Jorde R, Mellgren SI. Early diabetic neuropathy: thermal thresholds and intraepidermal nerve fibre density in patients with normal nerve conduction studies. J Neurol. 2008;255(8):1197-1202. doi:10.1007/s00415-008-0872-0
- Lauria G, Hsieh ST, Johansson O, et al. European Federation of Neurological Societies/Peripheral Nerve Society Guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol. 2010;17(7):903-e49. doi:10.1111/j.1468-1331.2010.03023.x
- Petropoulos IN, Ponirakis G, Ferdousi M, et al. Corneal confocal microscopy: a biomarker for diabetic peripheral neuropathy. Clin Ther. 2021;43(9):1457-1475. doi:10.1016/j.clinthera.2021.04.003
- Alam U, Jeziorska M, Petropoulos IN, et al. Diagnostic utility of corneal confocal microscopy and intra-epidermal nerve fibre density in diabetic neuropathy. PLoS One. 2017;12(7):e0180175. doi:10.1371/journal.pone.0180175
- Gad H, Al-Jarrah B, Saraswathi S, et al. Corneal confocal microscopy identifies a reduction in corneal keratocyte density and sub-basal nerves in children with type 1 diabetes mellitus. Br J Ophthalmol. 2022;106(10):1368-1372. doi:10.1136/bjophthalmol-2021-319057
- Ferdousi M, Romanchuk K, Mah JK, Virtanen H, Millar C, Malik RA, Pacaud D. Early corneal nerve fibre damage and increased Langerhans cell density in children with type 1 diabetes mellitus. Sci Rep. 2019;9(1):8758. doi: 10.1038/s41598-019-45116-z
- Tavakoli M, Quattrini C, Abbott C, et al. Corneal confocal microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic neuropathy. Diabetes Care. 2010;33(8):1792-1797. doi:10.2337/dc10-0253
- Arcilla CK, Tadi P. Neuroanatomy, Unmyelinated Nerve Fibers. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554461/
- Wang M, Zhang C, Zuo A, Li L, Chen L, Hou X. Diagnostic utility of corneal confocal microscopy in type 2 diabetic peripheral neuropathy. J Diabetes Investig. 2021;12(4):574-582. doi: 10.1111/jdi.13381
- Bitirgen G, Ozkagnici A, Malik RA, Kerimoglu H. Corneal nerve fibre damage precedes diabetic retinopathy in patients with type 2 diabetes mellitus. Diabet Med. 2014;31(4):431-438. doi:10.1111/dme.12324
There are 21 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Ophthalmology and Optometry (Other) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 21, 2023 |
| Submission Date | August 27, 2023 |
| Acceptance Date | September 20, 2023 |
| Published in Issue | Year 2023 Volume: 6 Issue: 3 |
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