Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis
ABSTRACT Introduction Corneal confocal microscopy (CCM) is a rapid non‐invasive ophthalmic imaging technique that identifies corneal nerve fiber damage. Small studies suggest that CCM could be used to assess patients with diabetic peripheral neuropathy (DPN). Aim To undertake a systematic review and...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13643 |
| _version_ | 1819364549199921152 |
|---|---|
| author | Hoda Gad Ioannis N Petropoulos Adnan Khan Georgios Ponirakis Ross MacDonald Uazman Alam Rayaz A Malik |
| author_facet | Hoda Gad Ioannis N Petropoulos Adnan Khan Georgios Ponirakis Ross MacDonald Uazman Alam Rayaz A Malik |
| author_sort | Hoda Gad |
| collection | DOAJ |
| description | ABSTRACT Introduction Corneal confocal microscopy (CCM) is a rapid non‐invasive ophthalmic imaging technique that identifies corneal nerve fiber damage. Small studies suggest that CCM could be used to assess patients with diabetic peripheral neuropathy (DPN). Aim To undertake a systematic review and meta‐analysis assessing the diagnostic utility of CCM for sub‐clinical DPN (DPN−) and established DPN (DPN+). Data sources Databases (PubMed, Embase, Central, ProQuest) were searched for studies using CCM in patients with diabetes up to April 2020. Study selection Studies were included if they reported on at least one CCM parameter in patients with diabetes. Data extraction Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and inferior whorl length (IWL) were compared between patients with diabetes with and without DPN and controls. Meta‐analysis was undertaken using RevMan V.5.3. Data synthesis Thirty‐eight studies including ~4,000 participants were included in this meta‐analysis. There were significant reductions in CNFD, CNBD, CNFL, and IWL in DPN− vs controls (P < 0.00001), DPN+ vs controls (P < 0.00001), and DPN+ vs DPN− (P < 0.00001). Conclusion This systematic review and meta‐analysis shows that CCM detects small nerve fiber loss in subclinical and clinical DPN and concludes that CCM has good diagnostic utility in DPN. |
| first_indexed | 2024-12-24T23:00:42Z |
| format | Article |
| id | doaj.art-b7b1d145c795440288c67a1dc9f2152d |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-24T23:00:42Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-b7b1d145c795440288c67a1dc9f2152d2022-12-21T16:35:08ZengWileyJournal of Diabetes Investigation2040-11162040-11242022-01-0113113414710.1111/jdi.13643Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysisHoda Gad0Ioannis N Petropoulos1Adnan Khan2Georgios Ponirakis3Ross MacDonald4Uazman Alam5Rayaz A Malik6Department of Medicine Weill Cornell Medicine‐Qatar Doha QatarDepartment of Medicine Weill Cornell Medicine‐Qatar Doha QatarDepartment of Medicine Weill Cornell Medicine‐Qatar Doha QatarDepartment of Medicine Weill Cornell Medicine‐Qatar Doha QatarLibrary Services Weill Cornell Medicine‐Qatar Doha QatarDiabetes and Neuropathy Research Department of Eye and Vision Sciences and Pain Research Institute Institute of Ageing and Chronic Disease University of Liverpool and Aintree University Hospital NHS Foundation Trust Liverpool UKDepartment of Medicine Weill Cornell Medicine‐Qatar Doha QatarABSTRACT Introduction Corneal confocal microscopy (CCM) is a rapid non‐invasive ophthalmic imaging technique that identifies corneal nerve fiber damage. Small studies suggest that CCM could be used to assess patients with diabetic peripheral neuropathy (DPN). Aim To undertake a systematic review and meta‐analysis assessing the diagnostic utility of CCM for sub‐clinical DPN (DPN−) and established DPN (DPN+). Data sources Databases (PubMed, Embase, Central, ProQuest) were searched for studies using CCM in patients with diabetes up to April 2020. Study selection Studies were included if they reported on at least one CCM parameter in patients with diabetes. Data extraction Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and inferior whorl length (IWL) were compared between patients with diabetes with and without DPN and controls. Meta‐analysis was undertaken using RevMan V.5.3. Data synthesis Thirty‐eight studies including ~4,000 participants were included in this meta‐analysis. There were significant reductions in CNFD, CNBD, CNFL, and IWL in DPN− vs controls (P < 0.00001), DPN+ vs controls (P < 0.00001), and DPN+ vs DPN− (P < 0.00001). Conclusion This systematic review and meta‐analysis shows that CCM detects small nerve fiber loss in subclinical and clinical DPN and concludes that CCM has good diagnostic utility in DPN.https://doi.org/10.1111/jdi.13643CCMDiabetic peripheral neuropathyDiagnosis |
| spellingShingle | Hoda Gad Ioannis N Petropoulos Adnan Khan Georgios Ponirakis Ross MacDonald Uazman Alam Rayaz A Malik Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis Journal of Diabetes Investigation CCM Diabetic peripheral neuropathy Diagnosis |
| title | Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis |
| title_full | Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis |
| title_fullStr | Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis |
| title_full_unstemmed | Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis |
| title_short | Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis |
| title_sort | corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy a systematic review and meta analysis |
| topic | CCM Diabetic peripheral neuropathy Diagnosis |
| url | https://doi.org/10.1111/jdi.13643 |
| work_keys_str_mv | AT hodagad cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis AT ioannisnpetropoulos cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis AT adnankhan cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis AT georgiosponirakis cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis AT rossmacdonald cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis AT uazmanalam cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis AT rayazamalik cornealconfocalmicroscopyforthediagnosisofdiabeticperipheralneuropathyasystematicreviewandmetaanalysis |