May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Monitoring Nerve Regeneration in Corneal Diabetic Neuropathy With Corneal Confocal Microscopy
Author Affiliations & Notes
  • E. Midena
    Ophthalmology, University of Padova, Padova, Italy
    Fondazione GB Bietti, IRCCS, Roma, Italy
  • S. Vujosevic
    Fondazione GB Bietti, IRCCS, Roma, Italy
  • S. Miotto
    Ophthalmology, University of Padova, Padova, Italy
  • M. Cortese
    Ophthalmology, University of Padova, Padova, Italy
  • E. Benetti
    Ophthalmology, University of Padova, Padova, Italy
  • A. Ghirlando
    Ophthalmology, University of Padova, Padova, Italy
  • Footnotes
    Commercial Relationships  E. Midena, None; S. Vujosevic, None; S. Miotto, None; M. Cortese, None; E. Benetti, None; A. Ghirlando, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2261. doi:https://doi.org/
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    • Get Citation

      E. Midena, S. Vujosevic, S. Miotto, M. Cortese, E. Benetti, A. Ghirlando; Monitoring Nerve Regeneration in Corneal Diabetic Neuropathy With Corneal Confocal Microscopy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2261. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Corneal diabetic neuropathy (CDN) is a hallmark of peripheral diabetic neuropathy. In this study, we investigate corneal subbasal nerve plexus changes in CDN using corneal confocal microscopy .

Methods: : 30 consecutive diabetic patients affected in both eyes by CDN ( subasal plexus nerve changes) were investigated and followed using corneal confocal microscopy (Confoscan4, Nidek, Japan). A new validated technique for subasal nerve plexus detection and examination was applied. Corneal confocal microscopy parameters for nerve changes were: number and density of nerve fibers, nerve tortuosity and branching, number of nerve beadings. Two masked examiners evaluated and quantified corneal confocal microscopy images.

Results: : Corneal confocal microscopy allowed in all cases a quantitative analysis of subbasal nerve plexus. Intra and inter-examiner agreement for confocal microscopy images were almost perfect (k= 0.95 and 0.92 , respectively). Significant Increase of nerve beadings (p <0.005) and reduction in nerve tortuosity ( p<0.004) were the distinctive parameters of nerve regeneration. Increase of nerves density and fibers was a late phaenomenon.

Conclusions: : These results show that corneal confocal microscopy is the key diagnostic technique in evaluating and monitoring CDN. Quantification of corneal subbasal nerve plexus parameters allows a correct, reproducible and objective, in vivo, non invasive approach to CDN, allowing to characterize peripheral diabetic neuropathay, a potentially highly diasbling complication of diabetes.

Keywords: diabetes • cornea: clinical science • neuroprotection 
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