2型糖尿病患者眼底改变与角膜密度的相关性分析

目的：定量分析2型糖尿病患者人群的角膜密度值并评估角膜密度与糖尿病视网膜病变（ DR）的关系，为临床应用提供依据。方法前瞻性比较性临床研究。选择2型糖尿病患者120例（240只眼）和正常对照组100例（200只眼），其中糖尿病患者分为三组：散瞳后未见任何眼底异常有52只眼（A组），非增生期DR 112只眼（ B组），增生期DR 76只眼（ C组）。利用Pentacam眼前节全景仪定量检测角膜密度，用方差分析比较糖尿病患者人群与正常人群角膜密度值的差异。用偏相关系数控制年龄因素之后，用Spearman相关分析评价角膜密度值与DR级别的相关性。结果2型糖尿病患者角膜密度值平均为（24．78±4．98），健康对照组角膜密度值平均为（21.17±3．45）。非增生期及增生期DR的2型糖尿病患者角膜密度高于健康对照组，且差异具有统计学意义（ P＜0.05）。2型糖尿病患者的角膜密度值与DR别呈正相关。结论2型糖尿病患者角膜密度较正常人群高，且与DR级别存在统计学相关性，角膜密度值可能是一种潜在的DR早期的筛查指标。

Relationship between fundus lesions and corneal density in type 2 diabetic patients

Objective To investigate the correlation of corneal density to diabetic retinopathy by specifically ana-lyzing corneal density values in type 2 diabetic population;to provide the information for better clinical management of type 2 diabetes.Methods This is a prospective and comparative clinical study.One hundred and twenty type 2 diabetic pa-tients (240 eyes) and 100 healthy subjects (200 eyes) were investigated.Diabetic patients were further divided into three groups:52 eyes with no fundus abnormality ( group A) , 112 eyes with non-proliferative diabetic retinopathy ( group B) and 76 eyes with proliferative diabetic retinopathy ( group C) .The corneal density was quantitatively measured using OCULUS Pentacam anterior segment analyzer.The differences in corneal density between diabetic patients and normal subjects were compared with analysis of variance.We also evaluated the correlation between cornea density and the level of diabetic reti-nopathy by applying Spearman correlation coefficient analysis after age was controlled.Results Average corneal density was 24.78 ±4.98 in diabetic patients and 21.17 ±3.45 in normal subjects.Corneal density in group B and C were signifi-cantly higher than that in normal subjects ( P <0.05).There is a positive correlation between corneal density and the de-gree of diabetic retinopathy.Conclusions Corneal density becomes higher in type 2 diabetic patients.A positive correla-tion was found between corneal density and degree of diabetic retinopathy.This suggested that corneal density may be an in-dicator for early screening of diabetic retinopathy.