AIMS/HYPOTHESIS: The accurate detection, characterization and quantification of human diabetic neuropathy are important to define at risk patients, anticipate deterioration, and assess new therapies. Corneal confocal microscopy is a reiterative, rapid, non-invasive in vivo clinical examination technique capable of imaging corneal nerve fibres. The aim of this study was to define the ability of this technique to quantify the extent of degeneration and regeneration of corneal nerve fibres in diabetic patients with increasing neuropathic severity. METHODS: We scanned the cornea and collected images of Bowman's layer (containing a rich nerve plexus) from 18 diabetic patients and 18 age-matched control subjects. RESULTS: Corneal nerve fibre density (F(3)=9.6, p<0.0001), length (F(3)=23.8, p<0.0001), and branch density (F(3)=13.9, p<0.0001) were reduced in diabetic patients compared with control subjects, with a tendency for greater reduction in these measures with increasing severity of neuropathy. CONCLUSION/ INTERPRETATION: Corneal confocal microscopy is a rapid, non-invasive in vivo clinical examination technique which accurately defines the extent of corneal nerve damage and repair and acts as a surrogate measure of somatic neuropathy in diabetic patients. It could represent an advance to define the severity of neuropathy and expedite assessment of therapeutic efficacy in clinical trials of human diabetic neuropathy.
AIMS/HYPOTHESIS: The accurate detection, characterization and quantification of humandiabetic neuropathy are important to define at risk patients, anticipate deterioration, and assess new therapies. Corneal confocal microscopy is a reiterative, rapid, non-invasive in vivo clinical examination technique capable of imaging corneal nerve fibres. The aim of this study was to define the ability of this technique to quantify the extent of degeneration and regeneration of corneal nerve fibres in diabeticpatients with increasing neuropathic severity. METHODS: We scanned the cornea and collected images of Bowman's layer (containing a rich nerve plexus) from 18 diabeticpatients and 18 age-matched control subjects. RESULTS: Corneal nerve fibre density (F(3)=9.6, p<0.0001), length (F(3)=23.8, p<0.0001), and branch density (F(3)=13.9, p<0.0001) were reduced in diabeticpatients compared with control subjects, with a tendency for greater reduction in these measures with increasing severity of neuropathy. CONCLUSION/ INTERPRETATION: Corneal confocal microscopy is a rapid, non-invasive in vivo clinical examination technique which accurately defines the extent of corneal nerve damage and repair and acts as a surrogate measure of somatic neuropathy in diabeticpatients. It could represent an advance to define the severity of neuropathy and expedite assessment of therapeutic efficacy in clinical trials of humandiabetic neuropathy.
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Authors: C A Abbott; A L Carrington; H Ashe; S Bath; L C Every; J Griffiths; A W Hann; A Hussein; N Jackson; K E Johnson; C H Ryder; R Torkington; E R E Van Ross; A M Whalley; P Widdows; S Williamson; A J M Boulton Journal: Diabet Med Date: 2002-05 Impact factor: 4.359
Authors: M Donaghy; R N Hakin; J M Bamford; A Garner; G R Kirkby; B A Noble; M Tazir-Melboucy; R H King; P K Thomas Journal: Brain Date: 1987-06 Impact factor: 13.501
Authors: Janneke G Hoeijmakers; Catharina G Faber; Giuseppe Lauria; Ingemar S Merkies; Stephen G Waxman Journal: Nat Rev Neurol Date: 2012-05-29 Impact factor: 42.937