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Corneal confocal microscopy is a non-invasive surrogate of nerve fibre damage and repair in diabetic patients

Tavakoli, Mitra, Quattrini, Christian, Abbott, Caroline, Kallinikos, Panagiotis A., Tomlinson, David, Efron, Nathan, Boulton, Andrew J., & Malik, Rayaz A. (2006) Corneal confocal microscopy is a non-invasive surrogate of nerve fibre damage and repair in diabetic patients. Contact Lens and Anterior Eye, 29(4), p. 207.

Abstract

Purpose: The accurate detection and quantification of human diabetic neuropathy are important to define at risk patients, anticipate deterioration, and assess new therapies. Current methods either lack sensitivity, require expert assessment (neurophysiology) or are highly invasive (skin/nerve biopsy). Corneal confocal microscopy is a rapid (2 min) non-invasive in vivo clinical examination technique capable of quantifying corneal small nerve fibre morphology. We stratified 102 diabetic patients aged (58 12 years), duration of diabetes (15 11yrs) in accordance with severity of somatic neuropathy using the Neuropathy Deficit Score (NDS) (none (1.3 0.9, n = 33), mild (3.9 0.6, n = 37), moderate (6.8 0.9, n = 22) and severe (9.8 0.5, n = 12)) and compared to 18 age-matched control subjects (55.4 8.2 years). Corneal sensitivity using non-contact (NCCA) ( p = 0.0001) and contact (Cochet- Bonnett) (CCA) aesthesiometry ( p = 0.007) decreased significantly with increasing neuropathic severity and correlated with each other ( p = 0.007). NDS correlated with reduction in corneal sensitivity (NCCA ( p = 0.0001), CCA ( p = 0.008)). Corneal nerve fibre density (NFD, p < 0.0001), nerve fibre length (NFL, p = 0.01), nerve fibre branch density (NBD) ( p < 0.0001) decreased and nerve fibre tortuosity (NFT) ( p = 0.008) increased in diabetic patients compared with control subjects. Furthermore, there was a significant correlation between NDS and NFD ( p = 0.0001), NBD ( p = 0.004) and NFL ( p = 0.011). Corneal sensitivity may be used as a simple clinical means to assess severity of somatic neuropathy. Furthermore, corneal confocal microscopy is a rapid, non-invasive in vivo clinical examination technique which accurately defines corneal nerve damage and repair and acts as a surrogate measure of somatic neuropathy. It represents a significant advance to simply and reiteratively quantify severity of neuropathy and may help expedite assessment of therapeutic efficacy in clinical trials of human diabetic neuropathy.

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ID Code: 11795
Item Type: Journal Article
Additional Information: For more information, please refer to the journal's website (see hypertext link) or contact the author.
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ISSN: 1367-0484
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Vision Science (111303)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Optical Technology (111302)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2006 Elsevier
Deposited On: 11 Jan 2008
Last Modified: 11 Aug 2011 03:47

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