Corneal confocal microscopy: A novel means to detect nerve fibre damage in idiopathic small fibre neuropathy

摘要: Patients with idiopathic small fibre neuropathy (ISFN) have been shown to significant intraepidermal nerve loss and an increased prevalence of impaired glucose tolerance (IGT). It has suggested that the dysglycemia IGT additional metabolic risk factors may contribute damage in these patients. Twenty-five patients ISFN 12 aged-matched control subjects underwent a detailed evaluation neuropathic symptoms, neurological deficits (Neuropathy deficit score (NDS); Nerve Conduction Studies (NCS); Quantitative Sensory Testing (QST) Corneal Confocal Microscopy (CCM)) quantify pathology. Eight (32%) had IGT. Whilst all NDS, NCS QST except for warm thresholds were normal. sensitivity was reduced CCM demonstrated reduction corneal density (NFD) (P<0.0001), branch (NBD) length (NFL) (P<0.0001) increase tortuosity (NFT) (P<0.0001). However parameters did not differ between without IGT, nor they correlate BMI, lipids blood pressure. confocal microscopy provides sensitive non-invasive means detect abnormalities do relate damage.