Corneal confocal microscopy detects severe small fiber neuropathy in diabetic patients with Charcot neuroarthropathy.
J Diabetes Investig
; 9(5): 1167-1172, 2018 Sep.
Article
in En
| MEDLINE
| ID: mdl-29380548
ABSTRACT
AIMS/INTRODUCTION:
The aim of the present study was to identify the extent of small fiber neuropathy in diabetic patients with Charcot neuroarthropathy (CN). MATERIALS ANDMETHODS:
A total of 20 patients with CN were compared with 20 age- and diabetes duration-matched patients with type 2 diabetes and 20 age-matched control participants. All patients underwent corneal confocal microscopy with quantification of corneal nerve morphology and assessment for vibration perception threshold, and a subset of patients with CN underwent assessment of sudomotor function and neuropathic pain.RESULTS:
In patients with CN compared with type 2 diabetes patients and control participants, there was a significant reduction in corneal nerve fiber density (14.94 ± 8.23 vs 23.86 ± 7.71, P = 0.004 vs 34.84 ± 9.13, P < 0.001), corneal nerve branch density (18.61 ± 16.7 vs 41.62 ± 22.67, P = 0.032 vs 76.47 ± 38.44, P < 0.001) and corneal nerve fiber length (8.40 ± 4.83 vs 14.87 ± 4.76, P = 0.001 vs 21.24 ± 6.48, P < 0.001), electrochemical skin conductance on the feet (20.57 ± 13.99 vs 61.50 ± 22.26, P < 0.001 vs 76.23 ± 12.01, P < 0.001) and hands (30.86 ± 18.10 vs 61.13 ± 19.14, P = 0.001 vs 68.31 ± 11.96, P < 0.001), and a significant increase in the vibration perception threshold in the feet (38.46 ± 15.10 vs 14.15 ± 10.25, P < 0.001 vs 7.75 ± 4.01, P < 0.001).CONCLUSIONS:
Patients with diabetes and CN have severe large and particularly small fiber neuropathy.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Severity of Illness Index
/
Cornea
/
Diabetic Neuropathies
/
Small Fiber Neuropathy
Type of study:
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Diabetes Investig
Year:
2018
Type:
Article
Affiliation country:
Qatar