Journal
MUSCLE & NERVE
Volume 52, Issue 3, Pages 363-370Publisher
WILEY
DOI: 10.1002/mus.24553
Keywords
Diabetes; Autonomic Neuropathy; Corneal nerves; Corneal confocal microscopy
Categories
Funding
- CORE (the research charity of the British Society of Gastroenterology)
- Diabetes UK
- National Institutes of Health [R105991]
- Juvenile Diabetes Research Foundation International [27-2008-362]
- Manchester NIHR-Wellcome Trust Clinical Research Facility
Ask authors/readers for more resources
BackgroundDiabetic autonomic neuropathy (DAN) results in increased morbidity and mortality. The early diagnosis of DAN can be difficult and is commonly evaluated using cardiac autonomic function tests as a surrogate. However, they are not widely available, have limited sensitivity and specificity, and can be confounded by concomitant cardiovascular disease and medications. Methods: The diagnostic utility of corneal confocal microscopy for diagnosis of DAN was assessed. Thirty-four diabetic patients without [Composite Autonomic Scoring Scale (CASS)2] vs with (CASS>2) DAN and 18 healthy control subjects (HC) underwent detailed assessment of somatic and autonomic neuropathy, Composite Autonomic Symptom Scale (COMPASS), (CASS), and Corneal Confocal Microscopy (CCM). Results: Corneal nerve fiber density, branch density, and length showed a progressive and significant reduction in patients with DAN vs HC and those without DAN. CCM correlated highly significantly with COMPASS and CASS, and corneal nerve fiber parameters demonstrated a high sensitivity and specificity for diagnosis of DAN. Conclusions: This study demonstrates that corneal nerve damage detected using CCM can be deployed to diagnose subclinical and overt DAN. It therefore represents a rapid, non-invasive, highly sensitive and specific diagnostic test for DAN. Muscle Nerve, 2015 Muscle Nerve 52:363-370, 2015
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available