ArticleDiabetologia2023
Occurrence of corneal sub-epithelial microneuromas and axonal swelling in people with diabetes with and without (painful) diabetic neuropathy.
Article in Diabetologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Corneal Innervation Research at a Crossroads: A Tool-Driven Roadmap for the Future.Investigative ophthalmology & visual science · 2026Review
- Association of corneal nerve parameters with nerve abnormalities and neuropathic pain in prediabetes and type 2 diabetes: the Maastricht Study.Diabetologia · 2026Article
- Corneal confocal microscopy in fibromyalgia syndrome: small fiber neuropathy, and treatment outcomes.Eye (London, England) · 2026Article
- AI-Assisted detection of corneal nerve structural abnormalities in early diabetic keratopathy: development and validation of a deep learning framework.Scientific reports · 2026Article
- Dynamic transcriptomic profiling of dorsal root ganglia reveals stage-specific mechanisms in diabetic neuropathic pain.Frontiers in molecular neuroscience · 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
- Peripheral Neuropathy Symptoms and Ocular Surface Lesions in Patients with Type 2 Diabetes Mellitus and Dry Eye: A Clinical Correlational Study.Ophthalmology and therapy · 2025Article
- 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
- Diabetic Keratopathy: Redox Signaling Pathways and Therapeutic Prospects.Antioxidants (Basel, Switzerland) · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisNon-invasive in vivo corneal confocal microscopy is gaining ground as an alternative to skin punch biopsy to evaluate small-diameter nerve fibre characteristics. This study aimed to further explore corneal nerve fibre pathology in diabetic neuropathy.
methodsThis cross-sectional study quantified and compared corneal nerve morphology and microneuromas in participants without diabetes (n=27), participants with diabetes but without distal symmetrical polyneuropathy (DSPN; n=33), participants with non-painful DSPN (n=25) and participants with painful DSPN (n=18). Clinical and electrodiagnostic criteria were used to diagnose DSPN. ANCOVA was used to compare nerve fibre morphology in the central cornea and inferior whorl, and the number of corneal sub-epithelial microneuromas between groups. Fisher's exact tests were used to compare the type and presence of corneal sub-epithelial microneuromas and axonal swelling between groups.
resultsVarious corneal nerve morphology metrics, such as corneal nerve fibre length and density, showed a progressive decline across the groups (p<0.001). In addition, axonal swelling was present more frequently (p=0.018) and in higher numbers (p=0.03) in participants with painful compared with non-painful DSPN. The frequency of axonal distension, a type of microneuroma, was increased in participants with painful and non-painful DSPN compared to participants with diabetes but without DSPN and participants without diabetes (all p≤0.042). The combined presence of all microneuromas and axonal swelling was increased in participants with painful DSPN compared with all other groups (p≤0.026). CONCLUSIONS/
interpretationMicroneuromas and axonal swelling in the cornea increase in prevalence from participants with diabetes to participants with non-painful DSPN and participants with painful DSPN.
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