Corneal Confocal Microscopy Detects Neuropathy in Patients with Type 1 Diabetes Without Retinopathy or Microalbuminuria

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Apr 9

PMID 25853247

Citations 42

Authors

Ioannis N Petropoulos

Patrick Green

Agnes W S Chan

Uazman Alam

Hassan Fadavi

Andrew Marshall

Omar Asghar

Nathan Efron

Mitra Tavakoli

Rayaz A Malik

Affiliations

Soon will be listed here.

Abstract

Objective: Corneal innervation is increasingly used as a surrogate marker of human diabetic peripheral neuropathy (DPN) however its temporal relationship with the other microvascular complications of diabetes is not fully established. In this cross-sectional, observational study we aimed to assess whether neuropathy occurred in patients with type 1 diabetes, without retinopathy or microalbuminuria.

Materials And Methods: All participants underwent detailed assessment of peripheral neuropathy [neuropathy disability score (NDS), vibration perception threshold (VPT), peroneal motor nerve conduction velocity (PMNCV), sural sensory nerve conduction velocity (SSNCV) and in vivo corneal confocal microscopy (IVCCM)], retinopathy (digital fundus photography) and albuminuria status [albumin: creatinine ratio (ACR)].

Results: 53 patients with Type 1 diabetes with (n=37) and without retinopathy (n=16) were compared to control subjects (n=27). SSNCV, corneal nerve fibre (CNFD) and branch (CNBD) density and length (CNFL) were reduced significantly (p<0.001) in diabetic patients without retinopathy compared to control subjects. Furthermore, CNFD, CNBD and CNFL were also significantly (p<0.001) reduced in diabetic patients without microalbuminuria (n=39), compared to control subjects. Greater neuropathic severity was associated with established retinopathy and microalbuminuria.

Conclusions: IVCCM detects early small fibre damage in the absence of retinopathy or microalbuminuria in patients with Type 1 diabetes.

Citing Articles

Visual Evoked Potentials for the Detection of Diabetic Retinal Neuropathy.

Miura G Int J Mol Sci. 2023; 24(8).

PMID: 37108524 PMC: 10138821. DOI: 10.3390/ijms24087361.

Methods for evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review protocol.

Sandvik S, Sundling V, Lagali N BMJ Open. 2023; 13(4):e070017.

PMID: 37045576 PMC: 10106056. DOI: 10.1136/bmjopen-2022-070017.

Diabetic Retinopathy: Soluble and Imaging Ocular Biomarkers.

Ferrara M, Loda A, Coco G, Grassi P, Cestaro S, Rezzola S J Clin Med. 2023; 12(3).

PMID: 36769560 PMC: 9917666. DOI: 10.3390/jcm12030912.

Implementation of corneal confocal microscopy for screening and early detection of diabetic neuropathy in primary care alongside retinopathy screening: Results from a feasibility study.

Carmichael J, Fadavi H, Ishibashi F, Howard S, Boulton A, Shore A Front Endocrinol (Lausanne). 2022; 13:891575.

PMID: 36313738 PMC: 9597366. DOI: 10.3389/fendo.2022.891575.

Neurodegeneration of the cornea and retina in patients with type 1 diabetes without clinical evidence of diabetic retinopathy.

Carmichael J, Fadavi H, Tavakoli M Front Endocrinol (Lausanne). 2022; 13:790255.

PMID: 36277683 PMC: 9581164. DOI: 10.3389/fendo.2022.790255.

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