Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria.
<h4>Objective</h4>Corneal 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 w...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0123517 |
| _version_ | 1818589483474354176 |
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| author | Ioannis N Petropoulos Patrick Green Agnes W S Chan Uazman Alam Hassan Fadavi Andrew Marshall Omar Asghar Nathan Efron Mitra Tavakoli Rayaz A Malik |
| author_facet | Ioannis N Petropoulos Patrick Green Agnes W S Chan Uazman Alam Hassan Fadavi Andrew Marshall Omar Asghar Nathan Efron Mitra Tavakoli Rayaz A Malik |
| author_sort | Ioannis N Petropoulos |
| collection | DOAJ |
| description | <h4>Objective</h4>Corneal 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.<h4>Materials and methods</h4>All 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)].<h4>Results</h4>53 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 (p<0.001) in diabetic patients without retinopathy compared to control subjects. Furthermore, CNFD, CNBD and CNFL were also significantly (p<0.001) reduced in diabetic patients without microalbuminuria (n=39), compared to control subjects. Greater neuropathic severity was associated with established retinopathy and microalbuminuria.<h4>Conclusions</h4>IVCCM detects early small fibre damage in the absence of retinopathy or microalbuminuria in patients with Type 1 diabetes. |
| first_indexed | 2024-12-16T09:41:22Z |
| format | Article |
| id | doaj.art-66cb9be0cad54a85b9c91b830f684277 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T09:41:22Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-66cb9be0cad54a85b9c91b830f6842772022-12-21T22:36:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01104e012351710.1371/journal.pone.0123517Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria.Ioannis N PetropoulosPatrick GreenAgnes W S ChanUazman AlamHassan FadaviAndrew MarshallOmar AsgharNathan EfronMitra TavakoliRayaz A Malik<h4>Objective</h4>Corneal 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.<h4>Materials and methods</h4>All 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)].<h4>Results</h4>53 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 (p<0.001) in diabetic patients without retinopathy compared to control subjects. Furthermore, CNFD, CNBD and CNFL were also significantly (p<0.001) reduced in diabetic patients without microalbuminuria (n=39), compared to control subjects. Greater neuropathic severity was associated with established retinopathy and microalbuminuria.<h4>Conclusions</h4>IVCCM detects early small fibre damage in the absence of retinopathy or microalbuminuria in patients with Type 1 diabetes.https://doi.org/10.1371/journal.pone.0123517 |
| spellingShingle | Ioannis N Petropoulos Patrick Green Agnes W S Chan Uazman Alam Hassan Fadavi Andrew Marshall Omar Asghar Nathan Efron Mitra Tavakoli Rayaz A Malik Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria. PLoS ONE |
| title | Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria. |
| title_full | Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria. |
| title_fullStr | Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria. |
| title_full_unstemmed | Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria. |
| title_short | Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria. |
| title_sort | corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria |
| url | https://doi.org/10.1371/journal.pone.0123517 |
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