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Corneal confocal microscopy for assessment of diabetic peripheral neuropathy: a meta-analysis
  1. Min-Shan Jiang1,2,
  2. Ying Yuan3,
  3. Zhao-Xiang Gu4,
  4. Song-Lin Zhuang1
  1. 1Shanghai Key Lab of Modern Optical Systems, Engineering Research Center of Optical Instruments and Systems, Ministry of Education, University of Shanghai for Science and Technology, Shanghai, China
  2. 2Department of Biomedical Engineering, Florida International University, Miami, Florida, USA
  3. 3Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
  4. 4Department of Nuclear Medicine, Huadong Hospital, Fudan University, Shanghai, China
  1. Correspondence to Dr Ying Yuan, Department of Radiology, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, China; yuany83{at}163.com

Abstract

Purpose To evaluate the diagnostic performance of corneal confocal microscopy (CCM) in assessing corneal nerve parameters in patients with diabetic peripheral neuropathy (DPN).

Methods Studies in the literature that focused on CCM and DPN were retrieved by searching PubMed, Excerpt Medica Database (EMBASE) and China National Knowledge Infrastructure (CNKI) databases. RevMan V.5.3 software was used for the meta-analysis. The results are presented as weighted mean difference (WMD) with a corresponding 95% CI.

Results 13 studies with a total of 1680 participants were included in the meta-analysis. The pooled results showed that the corneal nerve fibre density, nerve branch density and nerve fibre length were significantly reduced (all p<0.00001) in the patients with DPN compared with healthy controls ((WMD=−18.07, 95% CI −21.93 to −14.20), (WMD=−25.35, 95% CI −30.96 to −19.74) and (WMD=−6.37, 95% CI −7.44 to −5.30)) and compared with the diabetic patients without DPN ((WMD=−8.83, 95% CI −11.49 to −6.17), (WMD=−13.54, 95% CI −20.41 to −6.66) and (WMD=−4.19, 95% CI −5.35 to −3.04)), respectively. No significant difference was found in the corneal nerve fibre tortuosity coefficient between diabetic patients with DPN and healthy controls (p=0.80) or diabetic patients without DPN (p=0.61).

Conclusions This meta-analysis suggested that CCM may be valuable for detecting and assessing early nerve damage in DPN patients.

  • Cornea
  • Diagnostic tests/Investigation
  • Imaging

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