Comparison of Novel Wide-Field In Vivo Corneal Confocal Microscopy With Skin Biopsy for Assessing Peripheral Neuropathy in Type 2 Diabetes.
Journal
Diabetes
ISSN: 1939-327X
Titre abrégé: Diabetes
Pays: United States
ID NLM: 0372763
Informations de publication
Date de publication:
01 07 2023
01 07 2023
Historique:
received:
17
10
2022
accepted:
10
04
2023
medline:
22
6
2023
pubmed:
15
4
2023
entrez:
14
4
2023
Statut:
ppublish
Résumé
Diabetic peripheral neuropathy (DPN) is a serious complication of diabetes, where skin biopsy assessing intraepidermal nerve fiber density (IENFD) plays an important diagnostic role. In vivo confocal microscopy (IVCM) of the corneal subbasal nerve plexus has been proposed as a noninvasive diagnostic modality for DPN. Direct comparisons of skin biopsy and IVCM in controlled cohorts are lacking, as IVCM relies on subjective selection of images depicting only 0.2% of the nerve plexus. We compared these diagnostic modalities in a fixed-age cohort of 41 participants with type 2 diabetes and 36 healthy participants using machine algorithms to create wide-field image mosaics and quantify nerves in an area 37 times the size of prior studies to avoid human bias. In the same participants, and at the same time point, no correlation between IENFD and corneal nerve density was found. Corneal nerve density did not correlate with clinical measures of DPN, including neuropathy symptom and disability scores, nerve conduction studies, or quantitative sensory tests. Our findings indicate that corneal and intraepidermal nerves likely mirror different aspects of nerve degeneration, where only intraepidermal nerves appear to reflect the clinical status of DPN, suggesting that scrutiny is warranted concerning methodologies of studies using corneal nerves to assess DPN. Comparison of intraepidermal nerve fiber density with automated wide-field corneal nerve fiber density in participants with type 2 diabetes revealed no correlation between these parameters. Intraepidermal and corneal nerve fibers both detected neurodegeneration in type 2 diabetes, but only intraepidermal nerve fibers were associated with clinical measures of diabetic peripheral neuropathy. A lack of association of corneal nerves with peripheral neuropathy measures suggests that corneal nerve fibers may be a poor biomarker for diabetic peripheral neuropathy.
Identifiants
pubmed: 37058418
pii: 148721
doi: 10.2337/db22-0863
pmc: PMC10281223
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
908-917Informations de copyright
© 2023 by the American Diabetes Association.
Références
Diabetes. 2003 Oct;52(10):2615-22
pubmed: 14514647
Front Med (Lausanne). 2022 Feb 18;9:832344
pubmed: 35252263
Neurology. 2004 Mar 9;62(5):774-7
pubmed: 15007129
Diabetes. 2014 Jul;63(7):2454-63
pubmed: 24574045
Arch Neurol. 1998 Dec;55(12):1513-20
pubmed: 9865794
Acta Neurol Scand. 2020 Jan;141(1):38-46
pubmed: 31549387
BMJ Open Diabetes Res Care. 2020 Dec;8(2):
pubmed: 33355206
Br J Ophthalmol. 2016 Jan;100(1):9-14
pubmed: 25677672
Eur J Neurol. 2005 Oct;12(10):747-58
pubmed: 16190912
Diabetes Care. 2010 Oct;33(10):2285-93
pubmed: 20876709
Diabetologia. 2011 Dec;54(12):3143-9
pubmed: 21909836
Diabetes Metab Res Rev. 2011 Oct;27(7):620-8
pubmed: 21695763
Invest Ophthalmol Vis Sci. 2020 Mar 9;61(3):48
pubmed: 32232351
Diabetes Care. 2015 Jun;38(6):1138-44
pubmed: 25795415
J Am Acad Dermatol. 2015 Feb;72(2):328-32
pubmed: 25484269
Sci Rep. 2020 Feb 25;10(1):3371
pubmed: 32099076
Clin Ther. 2018 Jun;40(6):828-849
pubmed: 29709457
Nat Rev Dis Primers. 2019 Jun 13;5(1):42
pubmed: 31197183
J Peripher Nerv Syst. 2015 Dec;20(4):387-91
pubmed: 26309146
Diabetes Res Clin Pract. 2019 Nov;157:107843
pubmed: 31518657
Curr Diab Rep. 2019 Aug 27;19(10):86
pubmed: 31456118
J Diabetes Investig. 2021 Sep;12(9):1642-1650
pubmed: 33714226
Neuron. 2007 Aug 2;55(3):353-64
pubmed: 17678850
Diabetes Res Clin Pract. 2018 Feb;136:85-92
pubmed: 29221815
Ophthalmol Ther. 2022 Dec;11(6):2211-2223
pubmed: 36184730
Diabetes Res Clin Pract. 2022 Apr;186:109063
pubmed: 34547367
J Clin Neuromuscul Dis. 2017 Mar;18(3):125-131
pubmed: 28221302
PLoS One. 2017 Jul 18;12(7):e0180175
pubmed: 28719619
Clin Exp Optom. 2012 May;95(3):348-54
pubmed: 22540156
Invest Ophthalmol Vis Sci. 2013 Oct 29;54(10):7091-102
pubmed: 24084094
Transl Vis Sci Technol. 2016 Sep 30;5(5):7
pubmed: 27730007
Diabetologia. 1998 Nov;41(11):1263-9
pubmed: 9833931
Diabet Med. 2020 Feb;37(2):326-334
pubmed: 30897245
J Peripher Nerv Syst. 2010 Jun;15(2):79-92
pubmed: 20626771
Invest Ophthalmol Vis Sci. 2017 Dec 1;58(14):6318-6327
pubmed: 29242906
J Diabetes Investig. 2021 Apr;12(4):592-600
pubmed: 32799429
Lancet Diabetes Endocrinol. 2015 Aug;3(8):653-63
pubmed: 26184671
J Refract Surg. 2006 Nov;22(9 Suppl):S1047-52
pubmed: 17444092
Sci Rep. 2021 Jan 21;11(1):1859
pubmed: 33479291
Diabetes. 2007 Aug;56(8):2148-54
pubmed: 17513704
Diagnostics (Basel). 2020 Aug 20;10(9):
pubmed: 32825514
Annu Rev Med. 1990;41:303-17
pubmed: 2184732
Diabetologia. 1998 Nov;41(11):1253-62
pubmed: 9833930
Diabet Med. 2022 Mar;39(3):e14691
pubmed: 34536243
J Clin Invest. 2010 Nov;120(11):3760-72
pubmed: 21041958
JAMA Neurol. 2016 Jun 1;73(6):684-90
pubmed: 27065313
Sci Data. 2021 Nov 26;8(1):306
pubmed: 34836991
Sci Data. 2018 Apr 24;5:180075
pubmed: 29688226
Diabet Med. 2009 Nov;26(11):1120-6
pubmed: 19929990