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A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Frequency: Quarterly

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 1998 December;40(4):299-303


Ear­ly dys­func­tion of ­iris sen­so­ry ­fibres in dia­bet­ic ­patients

Alessandri M., Marabini S.*, Sicuteri R.*, Boccuni M.*, Fanciullacci M.*

From the Divi­sion of Inter­nal Med­i­cine VII, Sie­na Hos­pi­tal, Sie­na, Ita­ly
* Insti­tute of Inter­nal Med­i­cine and Ther­a­peu­tics IV, Uni­ver­sity of Flor­ence, Flor­ence, Ita­ly

Back­ground. The ­present ­study was ­designed to pro­pose trans­cu­ta­ne­ous electri­cal ­nerve stim­u­la­tion (­TENS) of the infra­troch­lear ­nerve as a non­in­va­sive ­test use­ful in the detec­tion of ear­ly ­iris ­small ­nerve ­fibre dys­func­tion in ­patients ­with dia­betes mel­lit­us.
Meth­ods. A ­total of 32 dia­bet­ic ­patients ­with no symp­toms or ­signs of dia­bet­ic neu­rop­a­thy ­were ­enrolled ­from a clin­i­cal prac­tice. Six­teen of ­them, 6 wom­en and 10 men, rang­ing in age ­from 19 to 53 ­years, had ­been affect­ed by ­IDDM for 13±2 ­years. The remain­der, 6 wom­en and 10 men, age ­range 32 to 58 ­years, ­were suf­fer­ing ­from ­NIDDM (dura­tion of man­i­fes­ta­tion 5±1 ­years). Twen­ty-six ­healthy indi­vid­u­als, 11 wom­en and 15 men, rang­ing in age ­from 21 to 47 ­years, ­served as con­trols.
­Pupil ­area chang­es ­induced by ­TENS of the infra­troch­lear ­nerve ­were inves­ti­gat­ed. The electri­cal stim­u­lus was not pain­ful and con­sist­ed of a sin­gle ­square ­wave ­pulse of 40 mA inten­sity and 0.8 ms dura­tion. Meas­ure­ments ­were car­ried out by ­means of a TV mon­oc­u­lar elec­tron­ic pupil­lom­e­ter.
­Results. A ­clear-cut mio­sis was pro­voked in con­trols (p<0.01 ver­sus ­basal val­ues 100 sec to 220 sec ­from stim­u­la­tion). ­NIDDM ­patients ­also ­showed a miot­ic ­response, but it was slow­er in ­onset (p<0.05 ver­sus ­basal val­ues 140 sec ­after stim­u­la­tion) and short­er (p<0.01 at 180 sec ­from stim­u­la­tion) in dura­tion. No pupil­lary chang­es ­were reg­is­tered in ­IDDM ­patients.
Con­clu­sions. An abnor­mal­ity of ­iris sen­so­ry ­nerve ­fibres in induc­ing pupil­lary con­stric­tion was detect­ed in ­both dia­bet­ic ­groups. The dif­fer­enc­es in the sever­ity of the dys­func­tion ­could be relat­ed to the dif­fer­enc­es in dura­tion of the dis­ease ­among the dia­bet­ic ­patients in the two ­groups. In con­clu­sion, ­TENS of the infra­troch­lear ­nerve ­could rep­re­sent an orig­i­nal non­in­va­sive meth­od in detect­ing ear­ly ­iris sen­so­ry alter­a­tions in dia­bet­ic ­patients.

language: English


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