Corneal confocal microscopy detects early nerve fiber loss in type 2 diabetes patients

A study recently published in Diabetes found that corneal confocal microscopy and skin biopsy could detect early loss of small nerve fibers in patients recently diagnosed with type-2 diabetes.

Microscopic diabetes-related eye damage detected by new technique

The study looked at whether early nerve damage could be detected by corneal confocal microscopy, skin biopsy, and neurophysiological tests in 86 recently diagnosed type-2 diabetic patients and 48 control subjects.

According to researchers, the corneal confocal microscopy analysis using novel algorithms to reconstruct nerve fiber images was performed for all fibers and major nerve fibers only. Researchers assessed intraepidermal nerve fiber density in skin specimens. And neurophysiological measures included nerve conduction studies, quantitative sensory testing, and cardiovascular autonomic function tests.

When compared with control subjects, the study found that diabetic patients exhibited significantly reduced corneal nerve fiber length, fiber density, branch density, connecting points, intraepidermal nerve fiber density, and all the measures looked at in the neurophysiological tests.

Corneal confocal microscopy and skin biopsy were able to detect the early nerve fiber loss in the diabetic patients.

“These two techniques detect nerve pathologies largely in different groups of patients, suggesting a patchy manifestation pattern of small fiber neuropathy in various organs, possibly due to distinct underlying pathophysiological processes,” the study’s authors wrote.