Application of corneal laser confocal microscopy in diabetic retinopathy patients / 眼科新进展

ABSTRACT

Objective To investigate the value of corneal laser confocal microscope in the diagnosis of corneal subepithelial plexus,corneal cell density and morphological changes of patients with diabetic retinopathy (DR).Methods Together 94 cases of confirmed DR (114 eyes),including 41 cases of non-proliferative diabetic retinopathy (NPDR group,52 eyes) and 53 cases of proliferative diabetic retinopathy (PDR group,62 eyes) were selected from January 2016 to April 2017,and meanwhile,40 diabetic patients (40 eyes) with no fundus abnormality were grouped as control group.Corneal laser confocal microscopy was used to compare the corneal subepithelial plexus,corneal cell density and morphological changes in the three groups,Results The cell densities of the basal layer,the superficial stromal layer,the medium stromal layer and the deep stromal layer of the cornea in NPDR and PDR were significantly lower than those of the control group (all P ＜ 0.05),and the PDR group was significantly lower than the NPDR group (all P ＜ 0.05).The corneal endothelial cell density,hexagonal cell ratio,nerve fiber density,and nerve fiber length in the NPDR and PDR group were significantly lower than those in the control group (all P ＜ 0.05);and the variability of endothelial cell and nerve branch density in NPDR and PDR patients were significantly higher than those in the control group (all P ＜ 0.05).The corneal endothelial cell density,hexagonal cell ratio,nerve fiber density,and nerve fiber length in the PDR group was (1962.0-± 117.3) · mm-2,46.1％ ± 5.5％,(15.4 ± 3.3) · mm-2,(6.2 ± 2.7) mm · mm-2,respectively,which were significantly lower than those in the NPDR group [(2381.4 ± 144.0) · mm-2,58.2％ ±7.0％,(20.6 ±3.8) ·mm-2,(8.6 ± 2.4)mm · mm-2,respectively] (all P ＜ 0.05),but the variability of endothelial cell and nerve branch density in PDR group were significantly higher than those in the NPDR group (all P ＜ 0.05).Conclusion Corneal confocal microscopy can effectively observe the density and morphological changes in corneal subepithelial plexus and corneal cell in DR patients so as to provide guidance for clinical diagnosis and treatment.