ArticleEuropean journal of neurology2022
Corneal nerve loss is related to the severity of painful diabetic neuropathy.
Article in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Efficacy and Limitations of Corneal Confocal Microscopy in Evaluating ATTRv-PN.Brain and behavior · 2026Article
- Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study.Diabetologia · 2026Article
- Interrelationship Between Socioeconomic Status, Depression, and Neuropathy in People with Diabetes: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Methods for the evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review.BMJ open · 2025Article
- Corneal Nerve Morphology in Painful Diabetic Neuropathy: A Meta-Analysis of In Vivo Confocal Microscopy Studies.Biomedicines · 2025Review
- The intrinsic reason why complementary tests (clinical neurophysiology, neuroimaging, skin biopsy) cannot establish the diagnosis of neuropathic pain.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Diagnostic Accuracy of Perception Threshold Tracking in the Detection of Small Fiber Damage in Type 1 Diabetes.Journal of diabetes science and technology · 2024Observational
- Sustained corneal nerve loss predicts the development of diabetic neuropathy in type 2 diabetes.Frontiers in neuroscience · 2024Article
- Relationship between ocular surface pain and corneal nerve loss in dry eye diabetics: a cross-sectional study in Shenyang, China.BMJ open · 2023Article
- Prevention and Management Strategies for Diabetic Neuropathy.Life (Basel, Switzerland) · 2022Review
- Corneal Confocal Microscopy and the Nervous System: Introduction to the Special Issue.Journal of clinical medicine · 2022Article
- Corneal nerve loss is related to the severity of painful diabetic neuropathy.European journal of neurology · 2022Article
- Corneal Confocal Microscopy in the Diagnosis of Small Fiber Neuropathy: Faster, Easier, and More Efficient Than Skin Biopsy?Pathophysiology : the official journal of the International Society for Pathophysiology · 2021Review
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Authors and funding
11 authors.
Funding
Abstract
background and purposePreviously it has been shown that patients with painful diabetic neuropathy (PDN) have greater corneal nerve loss compared to patients with painless diabetic neuropathy. This study investigated if the severity of corneal nerve loss was related to the severity of PDN.
methodsParticipants with diabetic neuropathy (n = 118) and healthy controls (n = 38) underwent clinical and neurological evaluation, quantitative sensory testing, nerve conduction testing and corneal confocal microscopy and were categorized into those with no (n = 43), mild (n = 34) and moderate-to-severe (n = 41) neuropathic pain.
resultsCorneal nerve fibre density (p = 0.003), corneal nerve fibre length (p < 0.0001) and cold perception threshold (p < 0.0001) were lower and warm perception threshold was higher (p = 0.002) in patients with more severe pain, but there was no significant difference in the neuropathy disability score (p = 0.5), vibration perception threshold (p = 0.5), sural nerve conduction velocity (p = 0.3) and amplitude (p = 0.7), corneal nerve branch density (p = 0.06) and deep breathing heart rate variability (p = 0.08) between patients with differing severity of PDN. The visual analogue scale correlated significantly with corneal nerve fibre density (r = -0.3, p = 0.0002), corneal nerve branch density (r = -0.3, p = 0.001) and corneal nerve fibre length (r = -0.4, p < 0.0001). Receiver operating curve analysis showed that corneal nerve fibre density had an area under the curve of 0.78 with a sensitivity of 0.73 and specificity of 0.72 for the diagnosis of PDN.
conclusionsCorneal confocal microscopy reveals increasing corneal nerve fibre loss with increasing severity of neuropathic pain and a good diagnostic outcome for identifying patients with PDN.
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