FRIDAY, Aug. 17 (HealthDay News) -- Corneal confocal microscopy (CCM) may offer a non-invasive way to assess small nerve fiber damage in diabetics, which may help prevent foot ulcerations and amputations, according to a report in the August issue of Diabetes.
Cristian Quattrini, M.D., of the University of Manchester in Manchester, U.K., and colleagues selected 55 patients and 15 controls who underwent neurological exams and electrophysiology. They were tested for neuropathy by CCM and underwent a punch skin biopsy to undergo intraepidermal nerve fiber (IENF) assessment.
The researchers found both methods were effective in detecting nerve fiber damage but CCM was non-invasive while using IENF often took several biopsies. CCM also potentially reveals markers of the disease earlier than IENF by detecting reductions in the number of corneal nerve fiber bundles that correlates directly to neuropathy of the lower limbs. Early detection could help manage the disease through optimal glycemic control.
"In conclusion, an ideal surrogate marker for diabetic neuropathy should be easy to use, reliable, sensitive, and non-invasive to enable repeated assessment as often or as long as necessary to define progression or response to therapeutic intervention," the authors write. "We have demonstrated that whereas both techniques of CNF and IENF assessment accurately reflect the severity of somatic neuropathy, CCM provides a significant further advantage as it detects damage before detectable nerve dysfunction, but most importantly it is entirely non-invasive."
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