ArticleScientific reports2020
Corneal confocal microscopy detects small nerve fibre damage in patients with painful diabetic neuropathy.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Corneal Confocal Microscopy and Skin Biopsy to Differentiate Painful From Painless Diabetic Neuropathy: A Systematic Review With Multiple Meta-Analyses.European journal of neurology · 2026Pooled it
- Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta-analysis.Journal of diabetes investigation · 2022Pooled it
- Corneal nerve imaging in systemic neuropathy: A minireview of experimental and precision medicine applications.World journal of experimental medicine · 2026Review
- Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study.Diabetologia · 2026Article
- Increased C-reactive protein is associated with corneal nerve loss and painful neuropathic symptoms in Type 2 diabetes mellitus.Journal of diabetes investigation · 2026Article
- Diabetic Peripheral Neuropathy: Current Epidemiology, Diagnostic Advances, Biomarkers, and Management Strategies.Journal of diabetes research · 2026Review
- Modulation of ion channels as emerging therapeutic targets in the treatment of diabetic neuropathy.EXCLI journal · 2026Review
- Correlating corneal and meibomian gland morphology with diabetes duration in T2DMInternational journal of ophthalmology · 2026Article
- Association of the glucose metabolism continuum (fasting plasma glucose/HbA1c) with tear-film stability and secretion: ocular surface evidence across non-diabetes, prediabetes, and diabetes.Frontiers in endocrinology · 2026Article
- Diabetic Peripheral Neuropathy: New Diagnostics and Treatment Perspectives.Drugs & aging · 2026Review
- Methods for the evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review.BMJ open · 2025Article
- In Vivo Confocal Microscopy of the Cornea in Diagnosing Small Fibre Neuropathy: A Cross-Sectional Observational Study.Diagnostics (Basel, Switzerland) · 2025Article
- Corneal Nerve Morphology in Painful Diabetic Neuropathy: A Meta-Analysis of In Vivo Confocal Microscopy Studies.Biomedicines · 2025Review
- Early diagnosis and risk factors of diabetic peripheral neuropathy in type 1 diabetes: insights from current perception threshold testing.Frontiers in endocrinology · 2025Article
- Quantifying the Corneal Nerve Whorl Pattern.Translational vision science & technology · 2024Article
- Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes.Journal of diabetes science and technology · 2024Observational
- Circulating netrin-1 levels are reduced and related to corneal nerve fiber loss in patients with diabetic neuropathy.Journal of diabetes investigation · 2024Article
- Discontinuity third harmonic generation microscopy for label-free imaging and quantification of intraepidermal nerve fibers.Cell reports methods · 2024Article
- Painful Diabetic Neuropathy: The Need for New Approaches.Journal of diabetes science and technology · 2024Review
- Bibliometric and visual analysis of diabetic keratopathy research: trends, collaborations, and future directions.Frontiers in medicine · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neuropathic pain is believed to arise from damage to nociceptive C fibres in diabetic neuropathy (DN). We have utilised corneal confocal microscopy (CCM) to quantify the severity of small nerve fibre damage in relation to the severity of neuropathic pain and quality of life (QoL) in patients with and without painful DN. 30 controls and patients with painful (n = 78) and painless (n = 62) DN underwent assessment of large and small nerve fibre function, CCM, neuropathic symptoms (small fibre neuropathy symptom inventory questionnaire, neuropathic pain scale) and QoL (SF-36, pre-R-ODS and hospital anxiety and depression scale). Patients with painful compared to painless DN, had comparable neurophysiology and vibration perception, but lower corneal nerve fibre density (20.1 ± 0.87 vs. 24.13 ± 0.91, P = 0.005), branch density (44.4 ± 3.31 vs. 57.74 ± 3.98, P = 0.03), length (19.61 ± 0.81 vs. 22.77 ± 0.83, P = 0.01), inferior whorl length (18.03 ± 1.46 vs. 25.1 ± 1.95, P = 0.005) and cold sensation threshold (21.35 ± 0.99 vs. 26.08 ± 0.5, P < 0.0001) and higher warm sensation threshold (43.7 ± 0.49 vs. 41.37 ± 0.51, P = 0.004) indicative of small fibre damage. There was a significant association between all CCM parameters and the severity of painful neuropathic symptoms, depression score and QoL. CCM identifies small nerve fibre loss, which correlates with the severity of neuropathic symptoms and reduced QoL in patients with painful diabetic neuropathy.
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