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 Malik

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)3646-3651
Number of pages6
JournalDiabetes Care
Volume36
Issue number11
DOIs
Publication statusPublished - Nov 2013
Externally publishedYes

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Diabetic Neuropathies
Confocal Microscopy
Nerve Fibers
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Healthy Volunteers
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing
  • Medicine(all)

Cite this

Corneal nerve loss detected with corneal confocal microscopy is symmetrical and related to the severity of diabetic polyneuropathy. / Petropoulos, Ioannis N.; Alam, Uazman; Fadavi, Hassan; Asghar, Omar; Green, Patrick; Ponirakis, Georgios; Marshall, Andrew; Boulton, Andrew J M; Tavakoli, Mitra; Malik, Rayaz.

In: Diabetes Care, Vol. 36, No. 11, 11.2013, p. 3646-3651.

Research output: Contribution to journalArticle

Petropoulos, IN, Alam, U, Fadavi, H, Asghar, O, Green, P, Ponirakis, G, Marshall, A, Boulton, AJM, Tavakoli, M & Malik, R 2013, 'Corneal nerve loss detected with corneal confocal microscopy is symmetrical and related to the severity of diabetic polyneuropathy', Diabetes Care, vol. 36, no. 11, pp. 3646-3651. https://doi.org/10.2337/dc13-0193
Petropoulos, Ioannis N. ; Alam, Uazman ; Fadavi, Hassan ; Asghar, Omar ; Green, Patrick ; Ponirakis, Georgios ; Marshall, Andrew ; Boulton, Andrew J M ; Tavakoli, Mitra ; Malik, Rayaz. / Corneal nerve loss detected with corneal confocal microscopy is symmetrical and related to the severity of diabetic polyneuropathy. In: Diabetes Care. 2013 ; Vol. 36, No. 11. pp. 3646-3651.
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AU - Fadavi, Hassan

AU - Asghar, Omar

AU - Green, Patrick

AU - Ponirakis, Georgios

AU - Marshall, Andrew

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AU - Malik, Rayaz

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N2 - 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.

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