scholarly journals Corneal confocal microscopy detects severe small fiber neuropathy in diabetic patients with Charcot neuroarthropathy

2018 ◽  
Vol 9 (5) ◽  
pp. 1167-1172 ◽  
Author(s):  
Adnan Khan ◽  
Ioannis N Petropoulos ◽  
Georgios Ponirakis ◽  
Robert A Menzies ◽  
Omar Chidiac ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Small Fiber Neuropathy ◽  
Diabetic Patients ◽  
Charcot Neuroarthropathy ◽  
Small Fiber ◽  
Corneal Confocal Microscopy

scholarly journals Corneal Confocal Microscopy in the Diagnosis of Small Fiber Neuropathy: Faster, Easier, and More Efficient Than Skin Biopsy?

2021 ◽  
Vol 29 (1) ◽  
pp. 1-8
Author(s):  
Mariia V. Lukashenko ◽  
Natalia Y. Gavrilova ◽  
Anna V. Bregovskaya ◽  
Lidiia A. Soprun ◽  
Leonid P. Churilov ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Skin Biopsy ◽  
Nerve Fiber ◽  
Small Fiber Neuropathy ◽  
Fiber Damage ◽  
Advantages And Disadvantages ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Common Causes ◽  
Small Nerve

Chronic pain may affect 30–50% of the world’s population and an important cause is small fiber neuropathy (SFN). Recent research suggests that autoimmune diseases may be one of the most common causes of small nerve fiber damage. There is low awareness of SFN among patients and clinicians and it is difficult to diagnose as routine electrophysiological methods only detect large fiber abnormalities, and specialized small fiber tests, like skin biopsy and quantitative sensory testing, are not routinely available. Corneal confocal microscopy (CCM) is a rapid, non-invasive, reproducible method for quantifying small nerve fiber degeneration and regeneration, and could be an important tool for diagnosing SFN. This review considers the advantages and disadvantages of CCM and highlights the evolution of this technique from a research tool to a diagnostic test for small fiber damage, which can be a valuable contribution to the study and management of autoimmune disease.

scholarly journals Corneal Confocal Microscopy Identifies Small-Fiber Neuropathy in Subjects With Impaired Glucose Tolerance Who Develop Type 2 Diabetes

Diabetes Care ◽  
2015 ◽  
Vol 38 (8) ◽  
pp. 1502-1508 ◽  
Author(s):  
Shazli Azmi ◽  
Maryam Ferdousi ◽  
Ioannis N. Petropoulos ◽  
Georgios Ponirakis ◽  
Uazman Alam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Confocal Microscopy ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Develop Type

scholarly journals Small fiber neuropathy for assessment of disease severity in amyotrophic lateral sclerosis: corneal confocal microscopy findings

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jiayu Fu ◽  
Ji He ◽  
Yixuan Zhang ◽  
Ziyuan Liu ◽  
Haikun Wang ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Dendritic Cell ◽  
Confocal Microscopy ◽  
Disease Severity ◽  
Peripheral Region ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve ◽  
Lateral Sclerosis

Abstract Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder with progressive motor system impairment, and recent evidence has identified the extra-motor involvement. Small fiber neuropathy reflecting by sensory and autonomic disturbances in ALS has been reported to accompany the motor damage. However, non-invasive assessment of this impairment and its application in disease evaluation of ALS is scarce. We aim to evaluate the use of corneal confocal microscopy (CCM) to non-invasively quantify the corneal small fiber neuropathy in ALS and explore its clinical value in assessing disease severity of ALS. Methods Sixty-six patients with ALS and 64 healthy controls were included in this cross-sectional study. Participants underwent detailed clinical assessments and corneal imaging with in vivo CCM. Using ImageJ, the following parameters were quantified: corneal nerve length (IWL) and dendritic cell density (IWDC) in the inferior whorl region and corneal nerve fiber length (CNFL), nerve fiber density (CNFD), nerve branch density (CNBD), and dendritic cell density (CDC) in the peripheral region. Disease severity was evaluated using recognized scales. Results Corneal nerve lengths (IWL and CNFL) were lower while dendritic cell densities (IWDC and CDC) were higher in patients with ALS than controls in peripheral and inferior whorl regions (p < 0.05). Additionally, corneal nerve complexity in the peripheral region was greater in patients than controls with higher CNBD (p = 0.040) and lower CNFD (p = 0.011). IWL was significantly associated with disease severity (p < 0.001) and progression (p = 0.002) in patients with ALS. Patients with bulbar involvement showed significantly lower IWL (p = 0.014) and higher IWDC (p = 0.043) than patients without bulbar involvement. Conclusions CCM quantified significant corneal neuropathy in ALS, and alterations in the inferior whorl region were closely associated with disease severity. CCM could serve as a noninvasive, objective imaging tool to detect corneal small fiber neuropathy for clinical evaluation in ALS.

scholarly journals Corneal confocal microscopy detects small-fiber neuropathy in Charcot-Marie-Tooth disease type 1A patients

2012 ◽  
Vol 46 (5) ◽  
pp. 698-704 ◽  
Author(s):  
Mitra Tavakoli ◽  
Andy Marshall ◽  
Siddharth Banka ◽  
Ioannis N. Petropoulos ◽  
Hassan Fadavi ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Disease Type ◽  
Small Fiber Neuropathy ◽  
Charcot Marie Tooth ◽  
Charcot Marie Tooth Disease ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Tooth Disease

scholarly journals Small fiber neuropathy in Parkinson's disease: A clinical, pathological and corneal confocal microscopy study

2015 ◽  
Vol 21 (12) ◽  
pp. 1454-1460 ◽  
Author(s):  
Lewis Kass-Iliyya ◽  
Saad Javed ◽  
David Gosal ◽  
Christopher Kobylecki ◽  
Andrew Marshall ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Confocal Microscopy ◽  
Microscopy Study ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
Corneal Confocal Microscopy

scholarly journals Diagnosing small fiber neuropathy in clinical practice: a deep phenotyping study

2021 ◽  
Vol 14 ◽  
pp. 175628642110043
Author(s):  
Nadine Egenolf ◽  
Caren Meyer zu Altenschildesche ◽  
Luisa Kreß ◽  
Katja Eggermann ◽  
Barbara Namer ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Punch Biopsy ◽  
Small Fiber Neuropathy ◽  
Fiber Density ◽  
Axon Reflex ◽  
Small Fiber ◽  
Corneal Confocal Microscopy ◽  
Intraepidermal Nerve Fiber Density ◽  
Number Of Patients ◽  
Skin Punch Biopsy

Background and aims: Small fiber neuropathy (SFN) is increasingly suspected in patients with pain of uncertain origin, and making the diagnosis remains a challenge lacking a diagnostic gold standard. Methods: In this case–control study, we prospectively recruited 86 patients with a medical history and clinical phenotype suggestive of SFN. Patients underwent neurological examination, quantitative sensory testing (QST), and distal and proximal skin punch biopsy, and were tested for pain-associated gene loci. Fifty-five of these patients additionally underwent pain-related evoked potentials (PREP), corneal confocal microscopy (CCM), and a quantitative sudomotor axon reflex test (QSART). Results: Abnormal distal intraepidermal nerve fiber density (IENFD) (60/86, 70%) and neurological examination (53/86, 62%) most frequently reflected small fiber disease. Adding CCM and/or PREP further increased the number of patients with small fiber impairment to 47/55 (85%). Genetic testing revealed potentially pathogenic gene variants in 14/86 (16%) index patients. QST, QSART, and proximal IENFD were of lower impact. Conclusion: We propose to diagnose SFN primarily based on the results of neurological examination and distal IENFD, with more detailed phenotyping in specialized centers.

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