Corneal nerve loss detected with corneal confocal microscopy is symmetrical and related to the severity of diabetic polyneuropathy

Ioannis N. Petropoulos, Uazman Alam, Hassan Fadavi, Omar Asghar, Patrick Green, Georgios Ponirakis, Andrew Marshall, Andrew J M Boulton, Mitra Tavakoli, Rayaz A. Malik

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    Abstract

    OBJECTIVE-To establish if corneal nerve loss, detected using in vivo corneal confocal microscopy (IVCCM), is symmetrical between right and left eyes and relates to the severity of diabetic neuropathy. RESEARCH DESIGN AND METHODS-Patients (n = 111) with type 1 and type 2 diabetes and 47 age-matched healthy control subjects underwent detailed assessment and stratification into no (n = 50), mild (n = 26), moderate (n = 17), and severe (n = 18) neuropathy. IVCCM was performed in both eyes and corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) and the tortuosity coefficient were quantified. RESULTS-All corneal nerve parameters differed significantly between diabetic patients and control subjects and progressively worsened with increasing severity of neuropathy. The reduction in CNFD, CNBD, and CNFL was symmetrical in all groups except in patients with severe neuropathy. CONCLUSIONS-IVCCM noninvasively detects corneal nerve loss, which relates to the severity of neuropathy, and is symmetrical, except in those with severe diabetic neuropathy. © 2013 by the American Diabetes Association.
    Original languageEnglish
    Pages (from-to)3646-3651
    Number of pages5
    JournalDiabetes Care
    Volume36
    Issue number11
    DOIs
    Publication statusPublished - Nov 2013

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