PLoS ONE (Jan 2015)

Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria.

  • Ioannis N Petropoulos,
  • Patrick Green,
  • Agnes W S Chan,
  • Uazman Alam,
  • Hassan Fadavi,
  • Andrew Marshall,
  • Omar Asghar,
  • Nathan Efron,
  • Mitra Tavakoli,
  • Rayaz A Malik

DOI
https://doi.org/10.1371/journal.pone.0123517
Journal volume & issue
Vol. 10, no. 4
p. e0123517

Abstract

Read online

ObjectiveCorneal innervation is increasingly used as a surrogate marker of human diabetic peripheral neuropathy (DPN) however its temporal relationship with the other microvascular complications of diabetes is not fully established. In this cross-sectional, observational study we aimed to assess whether neuropathy occurred in patients with type 1 diabetes, without retinopathy or microalbuminuria.Materials and methodsAll participants underwent detailed assessment of peripheral neuropathy [neuropathy disability score (NDS), vibration perception threshold (VPT), peroneal motor nerve conduction velocity (PMNCV), sural sensory nerve conduction velocity (SSNCV) and in vivo corneal confocal microscopy (IVCCM)], retinopathy (digital fundus photography) and albuminuria status [albumin: creatinine ratio (ACR)].Results53 patients with Type 1 diabetes with (n=37) and without retinopathy (n=16) were compared to control subjects (n=27). SSNCV, corneal nerve fibre (CNFD) and branch (CNBD) density and length (CNFL) were reduced significantly (pConclusionsIVCCM detects early small fibre damage in the absence of retinopathy or microalbuminuria in patients with Type 1 diabetes.