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

Malik, Rayaz A., Kallinikos, P., Abbott, Caroline, van Schie, Carine H. M., Morgan, Philip B., Efron, Nathan, & Boulton, Andrew J. M. (2003) Corneal confocal microscopy: a non-invasive surrogate of nerve fibre damage and repair in diabetic patients. Diabetologia, 46(5), pp. 683-688.

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Abstract

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 (F3=9.6, p<0.0001), length (F3=23.8, p<0.0001), and branch density (F3=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.

Impact and interest:

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112 citations in Web of Science®

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ID Code: 7971
Item Type: Journal Article
Additional Information: For more information, please refer to the publisher's website (link above) or contact the author: n.efron@qut.edu.au
Keywords: Diabetic neuropathy, confocal microscope, corneal nerves, surrogate, degeneration, regeneration
DOI: 10.1007/s00125-003-1086-8
ISSN: 1432-0428
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Optometry and Ophthalmology not elsewhere classified (111399)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Copyright Owner: Copyright 2003 Springer
Deposited On: 06 Jun 2007
Last Modified: 08 Aug 2013 12:09

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