ABSTRACT
RESUMEN La diabetes mellitus (DM) es una de las enfermedades sistémicas más comunes a nivel mundial con una prevalencia en incremento y una elevada tasa de mortalidad. La retinopatía diabética es una de las principales causas de ceguera en todas las latitudes del mundo. Aunque otras enfermedades oculares secundarias a diabetes también causan ceguera, su influencia en la superficie ocular es poco estudiada; sin embargo, el 73,6 por ciento de los pacientes diabéticos tipo 2 sufren de complicaciones corneales o de la superficie ocular. Se realizó una revisión de la bibliografía actualizada en idiomas español e inglés, a la que se pudo acceder, disponible en textos completos y resúmenes en bases de datos como PubMed, Ebsco, Google Académico y Scielo. Además, se consultaron novedosos artículos en prestigiosas revistas especializadas, con el objetivo de brindar información actualizada sobre la influencia de la diabetes en la superficie ocular. La diabetes mellitus tiene un impacto adverso en la superficie ocular. La gravedad de la neuropatía corneal diabética se correlaciona con la neuropatía periférica diabética. El estudio de la superficie ocular, así como de la retina, es importante para el tratamiento óptimo de la diabetes. Se han introducido novedosas opciones terapéuticas, pero todavía hay muchas en fase investigativa para los trastornos de la superficie ocular asociados con la diabetes(AU)
ABSTRACT Diabetes mellitus (DM) is one of the most common systemic diseases worldwide with an increasing prevalence and a high mortality rate. Diabetic retinopathy is one of the leading causes of blindness in all the latitudes of the world. Although other eye diseases secondary to diabetes also cause blindness, such influence on the ocular surface is poorly studied; however, 73.6 percent of type 2 diabetic patients suffer from corneal or ocular surface complications. A review of the available updated bibliography in Spanish and English languages; was carried out from full texts and abstracts in databases such as PubMed, Ebsco, Google Scholar, and Scielo. In addition, novel articles were consulted in prestigious specialized journals, with the aim of providing updated information on the influence of diabetes on the ocular surface. Diabetes mellitus has an adverse impact on the ocular surface. The severity of diabetic corneal neuropathy correlates with diabetic peripheral neuropathy. The study of the ocular surface, as well as the retina, is important for the optimal treatment of diabetes. Novel therapeutic options have been introduced, but there are still many in the investigative phase for ocular surface disorders associated with diabetes(AU)
Subject(s)
Humans , Review Literature as Topic , Diabetes Mellitus/epidemiology , Diabetic Neuropathies/therapy , Databases, BibliographicABSTRACT
@#AIM: To observe the changes of retinal nerve fiber layer(RNFL)and corneal nerve fibers(CNF)in diabetic patients without diabetic retinopathy(DR)retrospectively. <p>METHODS:Forty eyes of 40 patients with type 2 diabetes mellitus, who were found no diabetic retinopathy, were examined by optical coherence tomography(OCT)and <i>in vivo</i> confocal microscope(IVCM). Forty eyes of 40 healthy participants were only scanned using OCT served as RNFL control group, and another forty eyes of 40 healthy participants were only scanned using IVCM served as CNF control group. The thickness of superior, inferior, nasal, temporal and average RNFL to optic disc were measured using OCT. Corneal nerve fibers length(CNFL)and corneal nerve fibers density(CNFD)were measured using IVCM. <p>RESULTS: The diabetic patients showed decreased thickness of inferior RNFL when compared to controls(<i>P</i>=0.003).No significant differences were found in the thickness of superior, nasal, temporal and average RNFL(<i>P</i>>0.05). The diabetic patients were also found to have lower CNFL and CNFD(<i>P</i><0.01). What's more, in diabetes patients, the average RNFL were positively correlated with CNFL and CNFD(<i>r</i>=0.518, <i>P</i><0.01; <i>r</i>=0.484, <i>P</i>=0.002),and the inferior RNFL were also positively correlated with CNFL and CNFD(<i>r</i>=0.607, <i>P</i><0.01; <i>r</i>=0.573, <i>P</i><0.01). <p>CONCLUSION: RNFL and CNF are early damaged in diabetic patients without DR. RNFL decreases in the inferior quadrant of retina. The loss of RNFL positively correlates with that of CNF significantly.
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Sjögren Syndrome (SS) is one of the most frequent systemic autoimmune disorders, mainly involving the eye and mouth due to inflammation of lacrimal and salivary glands. Exocrine glands affected with a typical focal lymphocytic infiltration potentially lead to dry eyes and dry mouth. In addition to the known pathogenic mechanism of SS through autoimmunity, corneal neuropathy, as a peripheral neuropathy which is a relatively frequent extraglandular systemic manifestation of SS, recently draws attention as a possible pathogenic mechanism of ocular symptoms and dry eye induction. The diagnostic criteria of SS changed recently, proposed by the American College of Rheumatology/Sjögren's International Collaborative Clinical Alliance (ACR/SICCA) in 2012, and the ocular surface staining score is the only required test for ocular manifestation of SS. However, other diagnostic methods evaluating tear film status, though excluded from the new criteria, are still important for the staging and treatment planning, including direct observation of tear film, tear film break up time, Schirmer test, and measurement of the tear film levels of inflammatory mediators. Eye-specific symptoms and signs and ocular treatment options for SS including tear substitutes, secretogogue, topical anti-inflammatory therapy with corticosteroids and cyclosporine, punctal occlusion, autologous serum, and mucolytic therapy were summarized and discussed in this review article.
Subject(s)
Adrenal Cortex Hormones , Autoimmunity , Cyclosporine , Dry Eye Syndromes , Exocrine Glands , Inflammation , Mouth , Peripheral Nervous System Diseases , Salivary Glands , TearsABSTRACT
BackgroundWith the number of diabetics increases,people pay more attention to the diabetic keratopathy.The major mechanism leading to diabetic keratopathy is diabetic corneal neuropathy.So it is significant to observe pathologic mechanism of diabetic corneal neuropathy. Objective To investigate the protective effects of edaravone( a free radical scavenger) on corneal nerve of rats with experimental diabetic corneal neuropathy,then explain the effects of oxidative stress in the pathologic mechanism of diabetic corneal neuropathy. Methods Seventy Sprague-Daxley male rats were taken as experimental subjects and 20 of them were used as normal control group.The remaining 50 were induced to be diabetic mellitus by a single intraperitoneal injection of streptozotocin and divided into 2 groups randomly:edaravone treated group and diabetic control group.In the edaravone treated group,edaravone(0.2 g/L) eye drops were used 3 times a day until the animal was killed.Five rats in each group were sacrificed at 6,8,10 and 12 weeks respectively.Then the corneal sensation,number of corneal nerve fibers,morphology,content of malondialdehyde(MDA) and activity of superoxide dismutase(SOD) in the corneal tissue were detected.ResultsIn the diabetic control group,the corneal sensation and the number of corneal nerve fibers were decreased,the density of neural network for cluster was sparse,the nerve activity was decreased,the content of MDA in the corneal tissue was significantly increased,the activity of SOD in the corneal tissue was significantly decreased (P＜0.01 ).Accompany with the course of disease,the above change was obvious day after day.Compared with the diabetic control group,the corneal sensation and the morphological abnormalities in corneal nerve of edaravone group were improved significantly which had the partial branches to the 12th week,the content of MDA in the corneal tissue was significantly decreased,the activity of SOD in the corneal tissue was significantly increased (P＜0.01).Conclusions Edaravone can lower diabetic corneal nerve of rats with experimental diabetic corneal neuropathyinjury,Oxidative stress may be a critical pathologic mechanism of diabetic corneal neuropathy.