2018
DOI: 10.1111/jdi.12806
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Corneal confocal microscopy detects severe small fiber neuropathy in diabetic patients with Charcot neuroarthropathy

Abstract: Aims/IntroductionThe aim of the present study was to identify the extent of small fiber neuropathy in diabetic patients with Charcot neuroarthropathy (CN).Materials and MethodsA total of 20 patients with CN were compared with 20 age‐ and diabetes duration‐matched patients with type 2 diabetes and 20 age‐matched control participants. All patients underwent corneal confocal microscopy with quantification of corneal nerve morphology and assessment for vibration perception threshold, and a subset of patients with … Show more

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Cited by 26 publications
(21 citation statements)
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“…AST was lower in the present cohort with type 1 diabetes, and correlated with CNFD, CNBD and CNFL. No relationship between AST and CCM has been observed in studies in adults with diabetes 21,22,30,48 . Although the association between BMI and elevated AST is well established as a marker for liver injury in obese adults [49][50][51][52] , in the present study, AST was inversely correlated with BMI.…”
Section: Discussionmentioning
confidence: 95%
See 1 more Smart Citation
“…AST was lower in the present cohort with type 1 diabetes, and correlated with CNFD, CNBD and CNFL. No relationship between AST and CCM has been observed in studies in adults with diabetes 21,22,30,48 . Although the association between BMI and elevated AST is well established as a marker for liver injury in obese adults [49][50][51][52] , in the present study, AST was inversely correlated with BMI.…”
Section: Discussionmentioning
confidence: 95%
“…Corneal confocal microscopy (CCM) is a rapid, non-invasive and well-tolerated technique to detect and quantify neuropathy in adults with type 1 diabetes [17][18][19][20][21][22][23][24] . An early study found no significant changes in CCM parameters among children with Raynaud's phenomenon), previous corneal trauma or systemic disease that affects the cornea, surgery and a history of or current contact lens wear were excluded from the study.…”
Section: Introductionmentioning
confidence: 99%
“…Corneal confocal microscopy (CCM) is a noninvasive ophthalmic imaging technique for rapid, high-resolution imaging of corneal nerves. This technique has identified axonal loss in diabetes [21][22][23], impaired glucose tolerance [24], other peripheral neuropathies [25,26], Parkinson's disease [27], amyotrophic lateral sclerosis [28], multiple sclerosis [29] and dementia [30]. More recently we have shown a significant loss of corneal nerves in patients with TIA [31] and acute ischemic stroke [32][33][34], which was associated with elevated triglycerides and HbA 1c .…”
Section: Introductionmentioning
confidence: 90%
“…10,11 Corneal confocal microscopy has been used not only to detect changes in the corneal sub-epithelial nerve plexus in cornea-related dystrophies but also in a wide array of systemic and neurodegenerative diseases including diabetic peripheral neuropathy, rheumatoid arthritis, idiopathic small fiber neuropathy, Fabry disease, human immunodeficiency virusassociated peripheral neuropathy, and chemotherapy-induced peripheral neuropathy. 5,6,[12][13][14][15][16][17] Morphological changes of these nerves in both type 1 and type 2 diabetes has been shown to be a useful tool to diagnose and stratify the severity of peripheral neuropathy. 18 A recent meta-analysis assessing the diagnostic performance of corneal confocal microscopy in patients with diabetic peripheral neuropathy determined that corneal confocal microscopy to be valuable for detecting and assessing early nerve damage.…”
Section: Introductionmentioning
confidence: 99%