Assessing corneal nerve structure and function in diabetic neuropathy

Abstract

The accurate detection and quantification of human diabetic peripheral neuropathy are important to define at‐risk patients, anticipate deterioration and assess new therapies. Two emerging ophthalmic techniques, namely, corneal confocal microscopy and corneal aesthesiometry, demonstrate the ability to diagnose, quantify severity and assess therapeutic benefit in diabetic peripheral neuropathy. Corneal confocal microscopy allows quantification of corneal nerve morphology and non‐contact corneal aesthesiometry assesses corneal sensitivity. The present review provides a detailed critique of the rationale, practical application in terms of the instruments used to capture images and the basis on which images are interpreted and analysed. We also critically evaluate how these two new non‐invasive ophthalmic tests can be deployed to diagnose diabetic and other peripheral neuropathies.

Key words:

• cornea
• corneal nerves
• diabetes
• diabetic neuropathy
• in vivo corneal confocal microscopy (IVCCM)

ACKNOWLEDGEMENTS

The authors thank the Manchester Biomedical Research Centre and Manchester Wellcome Trust Clinical Research Facility for support with this research and providing the facilities.