Το σύνδρομο του ξηρού οφθαλμού στο σακχαρώδη διαβήτη: συσχέτιση με τη διαβητική νευροπάθεια

Doctoral Dissertation uoadl:1308348 306 Read counter

Unit:
Τομέας Χειρουργικής
Library of the School of Health Sciences
Deposit date:
2015-08-31
Year:
2015
Author:
Αχτσίδης Βασίλειος
Dissertation committee:
Αναπληρωτής καθηγητής Κωνσταντίνος Βουμβουράκης
Original Title:
Το σύνδρομο του ξηρού οφθαλμού στο σακχαρώδη διαβήτη: συσχέτιση με τη διαβητική νευροπάθεια
Languages:
Greek
Summary:
Objective- Aim
Neuropathy is probably the most common complication of diabetes and is
affecting the cornea since recent studies based on the in vivo corneal confocal
microscopy-(IVCCM) confirmed the decrease of cornea’s innervation depending on
the severity of diabetic neuropathy. The research hypothesis tested here was
that individuals with PN may have more chances of Dry Eye Syndrome (DES) as a
result of decreased sensitivity of the cornea and abnormal balance of tear
production/evaporation. Also, we investigated the correlations between
autonomic neuropathy (AN) and pupil reflexes.
Methods: A total of 61 patients with Type 2 Diabetes and 38 controls were
recruited into the study. They had dry eye measurements using the Schirmer I
test and tear film break-up time (TBut) based on DEWS criteria. Corneal
sensitivity assessment was performed using the Cochet-Bonnet aesthesiometer. We
also examined for diabetic peripheral neuropathy (PN) using neuropathy
disability score (NDS), neuropathy symptom score (NSS) and vibration perception
threshold (VPT). Moreover we studied the correlation between autonomic
neuropathy (AN) and pupil reflexes by using the Ewing’s criteria and a digital
pupilmeter.
Results: The mean values of the Schirmer I test, TBUT and corneal sensitivity
were significantly lower in patients with PN in comparison with those without
PN and controls (p<0.001). Cardiovascular AN measurements were correlated with
decreased mydriasis and dilation velocity (sympathetic dysfunction), and
decreased miosis and constriction velocity (parasympathetic dysfunction).
Conclusion: DES is common in subjects with diabetes and correlates with the
severity of PN. Subjects with diabetes who have PN should be screened for DES
and treated properly to avoid corneal surface disease and neuropathitic ulcer.
Autonomic neuropathy correlates with abnormal pupil reflexes. Overall, the
ophthalmological examination offers several biomarkers (corneal sensitivity,
dry eye measurements and pupil reflexes) which may contribute to the diagnosis
of Diabetic Neuropathy.
Keywords:
Diabetes mellitus, Dry eye, Sensitivity, Cornea, Diabetic neuropathy
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
230
Number of pages:
131
File:
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