ArticleNeurology2023
Assessing Corneal Confocal Microscopy and Other Small Fiber Measures in Diabetic Polyneuropathy.
Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 32 citations in OpenAlex.
- Comparison of intraepidermal nerve fiber density and confocal corneal microscopy for neuropathy.Annals of clinical and translational neurology · 2024Trial
- Corneal nerve imaging in systemic neuropathy: A minireview of experimental and precision medicine applications.World journal of experimental medicine · 2026Review
- Efficacy and Limitations of Corneal Confocal Microscopy in Evaluating ATTRv-PN.Brain and behavior · 2026Article
- Anatomy-guided weakly supervised learning framework for corneal nerve image denoising and enhancement.Biomedical optics express · 2026Article
- An Annotated Corneal Confocal Microscopy Dataset for Nerve Segmentation and Clinical Characterization.Scientific data · 2026Article
- Review
- Promising Biomarkers for Early Diagnosis: Advances in Understanding the Pathogenesis of Diabetic Peripheral Neuropathy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Review
- Impact of Diabetic Peripheral Neuropathy on Corneal Sensitivity and Ocular Surface.Ophthalmic research · 2026Observational
- Methods for the evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review.BMJ open · 2025Article
- The Correlation Between Functional and Morphometric Small Fiber Assessment in Mixed Etiology Polyneuropathy.Journal of the peripheral nervous system : JPNS · 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
- Quantitative sensory testing -Scandinavian journal of pain · 2025Article
- Article
- Assessing axonal pathology and disease progression in chronic inflammatory demyelinating polyneuropathy using corneal confocal microscopy.Journal of neurology · 2024Article
- Age-dependent small fiber neuropathy: Mechanistic insights from animal models.Experimental neurology · 2024Review
- Corneal subbasal nerve plexus reinnervation and stromal cell morphology with different cap thicknesses in small incision lenticule extraction.Eye and vision (London, England) · 2024Article
- Sustained corneal nerve loss predicts the development of diabetic neuropathy in type 2 diabetes.Frontiers in neuroscience · 2024Article
- Correlation Between Fibrinogen/Albumin and Diabetic Peripheral Neuropathy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Article
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesDamage to small nerve fibers is common in diabetic polyneuropathy (DPN), and the diagnosis of DPN relies on subjective symptoms and signs in a combination with objective confirmatory tests, typically electrophysiology or intraepidermal nerve fiber density (IENFD) from skin biopsy. Corneal confocal microscopy (CCM) has been introduced as a tool to detect DPN. However, it is unclear if CCM can reliably be used to diagnose DPN and how the technique compares with other commonly used measures of small fiber damage, such as IENFD, cold detection threshold (CDT), and warm detection threshold (WDT). Therefore, we assessed and compared the use of CCM, IENFD, CDT, and WDT in the diagnosis of DPN in patients with type 2 diabetes.
methodsIn this cohort study, the participants underwent detailed neurologic examination, electrophysiology, quantification of IENFD, CCM, and quantitative sensory testing. Definition of DPN was made in accordance with the Toronto criteria for diabetic neuropathy (without relying on IENFD and thermal thresholds).
resultsA total of 214 patients with at least probable DPN, 63 patients without DPN, and 97 controls without diabetes were included. Patients with DPN had lower CCM measures (corneal nerve fiber length [CNFL], nerve fiber density, and branch density), IENFD, CDT, and WDT compared with patients without DPN ( DISCUSSION: CCM measures showed the lowest sensitivity compared with other small fiber measures in the diagnosis of DPN. This indicates that CCM is not a sensitive method to detect DPN in recently diagnosed type 2 diabetes. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that CCM measures aid in the detection of DPN in recently diagnosed type 2 diabetics but with a low sensitivity when compared with other small fiber measures.
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