Změny tkání oka u pacientů s diabetem mellitem s důrazem na tkáně povrchu oka

• Thesis title in Czech: Změny tkání oka u pacientů s diabetem mellitem s důrazem na tkáně povrchu oka
• Thesis title in English: Changes in eye tissues in patients with diabetes mellitus, with emphasis on the tissue surface of the eye
• Key words: Konfokální mikroskopie rohovky, Diabetes mellitus 1.typu, Diabetická keratopatie, Nervová vlákna rohovky, Diabetická retinopatie, Diabetická neuropatie, Glykemická variabilita
• English key words: Corneal confocal microscopy, Diabetes mellitus type 1, Diabetic keratopathy, Corneal nerve fiber, Diabetic retinopathy, Diabetic neuropathy, Glucose variability
• Academic year of topic announcement: 2014/2015
• Thesis type: dissertation
• Thesis language: čeština
• Department: Department of Physiology (13-710)
• Supervisor: doc. MUDr. Gabriela Mahelková, Ph.D.
• Author: hidden - assigned and confirmed by the Study Dept.
• Date of registration: 01.04.2015
• Date of assignment: 01.04.2015
• Confirmed by Study dept. on: 01.04.2015
• Date and time of defence: 02.12.2019 14:00
• Date of electronic submission: 15.08.2019
• Date of submission of printed version: 15.08.2019
• Date of proceeded defence: 02.12.2019
• Opponents: doc. MUDr. Bohdana Kalvodová, CSc.

References

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2. Davidson EP, Coppey LJ, Yorek MA: Early loss of innervation of cornea epithelium in streptozotocin-induced type 1 diabetic rats: improvement with ilepatril treatment. Invest Ophthalmol Vis Sci. 2012;53(13): 8067–8074.
3. Hafner J, Karst S, Sacu S, Scholda C, Pablik E, Schmidt-Erfurth U: Correlation between corneal and retinal neurodegenerative changes and their association with microvascular perfusion in type II diabetes. Acta Ophthalmol. 2019; 97(4):e545-e550.
4. Chen DK, Frizzi KE, Guernsey LS, et al.: Repeated monitoring of corneal nerves by confocal microscopy as an index of peripheral neuropathy in type-1 diabetic rodents and the effects of topical insulin. J Peripher Nerv Syst. 2013; 18: 306–315.
5. Lagali N, Poletti E, Patel DV, et al.: Focused Tortuosity Definitions Based on Expert Clinical Assessment of Corneal Subbasal Nerves. Invest Ophthalmol Vis Sci,2015; 56:5102-5109.
6. Niederer RL, Perumal D, Sherwin T, McGhee CN: Age-related differences in the normal human cornea: a laser scanning in vivo confocal microscopy study. Br J Ophthalmol 2007; 91:1165-1169.
7. Shih KC, Lam KSL, Tong L: A systematic review on the impact of diabetes mellitus on the ocular surface. Nutr Diabetes. 2017; 7: e251.
8. Szalai E, Deak E, Modis L, Jr., et al.: Early Corneal Cellular and Nerve Fiber Pathology in Young Patients With Type 1 Diabetes Mellitus Identified Using Corneal Confocal Microscopy. Invest Ophthalmol Vis Sci 2016; 57:853-858.
9. Tavakoli M, Ferdousi M, Petropoulos IN, et al.: Normative values for corneal nerve morphology assessed using corneal confocal microscopy: a multinational normative data set. Diabetes Care, 2015;38: 838-843.
10. Utsunomiya T, Nagaoka T, Hanada K, et al.: Imaging of the Corneal Subbasal Whorl-like Nerve Plexus: More Accurate Depiction of the Extent of Corneal Nerve Damage in Patients With Diabetes. Invest Ophthalmol Vis Sci, 2015; 56: 5417-5423.
11. Virk SA, Donaghue KC, Cho YH, et al.: Association between HbA1c variability and risk of microvascular complications in adolescents with type 1 diabetes. J Clin Endocrinol MeTab 2016; 101: 3257–3263.
12. Wu YC, Buckner BR, Zhu M, Cavanagh HD, Robertson DM:. Elevated IGFBP3 levels in diabetic tears: a negative regulator of IGF-1 signaling in the corneal epithelium. Ocul Surf 2012; 10: 100–107.

Preliminary scope of work

Cíl práce: Zhodnotit možnou souvislost mezi změnami rohovky a diabetickou retinopatií (DR), dobou trvání DM 1 a věkem v době diagnózy DM 1 a parametry kompenzace diabetu.

Metodika: Do studie bylo zařazeno 60 pacientů s DM 1, z toho 20 pacientů v intenzifikovaném inzulínovém režimu, a 20 zdravých kontrolních subjektů. Účastnící studie byli vyšetřeni in vivo konfokálním mikroskopem rohovky (IVCM). Pomocí IVCM byla hodnocena denzita bazálních epiteliálních buněk, keratocytů a buněk endotelu a stav subbazálních nervových vláken rohovky [denzita nervových vláken rohovky (NFD), délka nervových vláken (NFL), denzita větvení nervových vláken (NBD) a tortuozita (NFT)]. Hodnoceny byly možné souvislosti mezi parametry kompenzace diabetu [glykovaný hemoglobin (HbA1c), glykémie a dávka inzulínu]a dalšími klinickými faktory.

Preliminary scope of work in English

Purpose: A possible association between changes in the cornea and diabetic retinopathy (DR), DM duration, age at the time of DM diagnosis, and parameters of diabetes compensation are evaluated.

Methods: The study included 60 patients with DM 1, among these 20 patients were treated with an intensified insulin regimen, and 20 healthy control subjects. The subjects were examined using in vivo corneal confocal microscopy (IVCM). The density of basal epithelial cells, keratocytes and endothelial cells, and the status of the subbasal nerve fibers [corneal nerve fiber density (NFD), nerve fiber length (NFL), nerve branch density (NBD), and tortuosity (NFT)] were evaluated using IVCM. Possible associations between parameters of diabetes compensation [glycated hemoglobin (HbA1c), glycemia, and insulin dose], and other clinical factors were analyzed.