誗AIM: To observe the changes of retinal nerve fiber layer (RNFL) and corneal nerve fibers (CNF) in diabetic patients without diabetic retinopathy(DR) retrospectively. 誗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 in vivo 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

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... ticipants 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. 誗 RESULTS: The diabetic patients showed decreased thickness of inferior RNFL when compared to controls(P = 0. 003). No significant differences were found in the thickness of superior, nasal, temporal and average RNFL (P>0. 05). The diabetic patients were also found to have lower CNFL and CNFD (P < 0. 01). What蒺s more, in diabetes patients, the average RNFL were positively correlated with CNFL and CNFD (r = 0. 518, P < 0. 01; r = 0郾 484, P = 0. 002) , and the inferior RNFL were also positively correlated with CNFL and CNFD (r = 0. 607, P < 0郾 01; r = 0. 573, P<0. 01). 誗 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. 誗 KEYWORDS: diabetes mellitus; corneal neuropathy; retinal nerve fiber layer; confocal microscope Citation:Fan W, Xiong XW, Bai L, et al. Retinal nerve fiber layer and corneal nerve loss in early stage of diabetic retinopathy. Guoji Yanke Zazhi(Int Eye Sci) 2017;17(4) :772-774 摘要 目的:观察无视网膜微血管病变的糖尿病患者的视网膜神 经纤维层(RNFL) 和角膜神经纤维(CNF) 变化,以及两者 变化的相关性。 方法:收集 40 例 40 眼 2 型糖尿病患者,经散瞳眼底检查 未发现 糖 尿 病 视 网 膜 病 变, 均 接 受 光 学 相 干 断 层 扫 描 (OCT) 检查和活体角膜共聚焦显微镜(IVCM) 检查。 另收 集年龄匹配的 80 例 80 眼健康正常眼为对照,分为 40 例 40 眼只行 OCT 检查的 RNFL 对照组和 40 例 40 眼 只 行 IVCM 检查的 CNF 对照组。 利用 OCT 观察视乳头上方、下 方、颞侧、鼻侧和平均 RNFL 厚度,用 IVCM 观察角膜上皮 下角膜神经纤维长度和角膜神经密度。 结果:糖尿病组的视乳头上方、颞侧、鼻侧及平均 RNFL 与 对照组比较,差异无统计学意义(P>0. 05) ,但视乳头下方 RNFL 糖尿病组比 RNFL 对照组减少,差异有统计学意义 (P = 0. 003) 。 糖尿病组的角膜神经纤维长度、角膜神经 密度均比 CNF 对照组减少(P<0. 01) 。 糖尿病组中,平均 RNFL 与角膜神经纤维长度和角膜神经密度呈正相关(r = 0. 518,P<0. 01;r = 0. 484,P = 0. 002) ,下方 RNFL 与角膜 神经纤维长度和角膜神经密度呈正相关 (r = 0. 607, P < 0郾 01;r = 0. 573,P<0. 01) 。