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.
Keywords: Cornea; Diagnostic tests/Investigation; Imaging.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/