Corneal confocal microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic neuropathy.

Objective: The accurate quantification of human diabetic neuropathy is important to define at-risk patients, anticipate deterioration, and assess new therapies.

Research Design And Methods: A total of 101 diabetic patients and 17 age-matched control subjects underwent neurological evaluation, neurophysiology tests, quantitative sensory testing, and evaluation of corneal sensation and corneal nerve morphology using corneal confocal microscopy (CCM).

Results: Corneal sensation decreased significantly (P = 0.

Efficacy of 2 types of silicone hydrogel bandage contact lenses after photorefractive keratectomy.

Purpose: To compare the efficacy of 2 types of silicone hydrogel bandage contact lenses with high oxygen transmissibility after photorefractive keratectomy (PRK).

Setting: Institute of Vision and Optics, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.

Methods: In this prospective study, 1 eye of patients having bilateral PRK was randomly fitted with a bandage contact lens of lotrafilcon A (Night & Day) and the fellow eye, with a bandage contact lens of lotrafilcon B (O(2)Optix).

Corneal confocal microscopy detects early nerve regeneration after pancreas transplantation in patients with type 1 diabetes.

Objective: Corneal confocal microscopy (CCM) is a rapid, noninvasive, clinical examination technique that quantifies small nerve fiber pathology. We have used it to assess the neurological benefits of pancreas transplantation in type 1 diabetic patients.

Research Design And Methods: In 20 patients with type 1 diabetes undergoing simultaneous pancreas and kidney transplantation (SPK) and 15 control subjects, corneal sensitivity was evaluated using noncontact corneal esthesiometry, and small nerve fiber morphology was assessed using CCM.

Surrogate markers of small fiber damage in human diabetic neuropathy.

Surrogate markers of diabetic neuropathy are being actively sought to facilitate the diagnosis, measure the progression, and assess the benefits of therapeutic intervention in patients with diabetic neuropathy. We have quantified small nerve fiber pathological changes using the technique of intraepidermal nerve fiber (IENF) assessment and the novel in vivo technique of corneal confocal microscopy (CCM). Fifty-four diabetic patients stratified for neuropathy, using neurological evaluation, neurophysiology, and quantitative sensory testing, and 15 control subjects were studied.

Assessment of stromal keratocytes and tear film inflammatory mediators during extended wear of contact lenses.

Purpose: To monitor quantitative changes in stromal keratocyte density and the level of tear film inflammatory mediators following extended contact lens wear.

Methods: Twenty-two subjects aged 32 +/- 11 years participated in this cross-sectional study. Eleven subjects had worn silicone hydrogel (Si-H) lenses on a 30-day continuous wear basis for 12 months.

On the etiology of keratocyte loss during contact lens wear.

Purpose: To employ confocal microscopy to investigate the etiology of keratocyte loss after short-term contact lens wear by monitoring quantitative changes in keratocyte density.

Methods: Twenty neophyte subjects aged 26 +/- 3 years participated in the study, which was conducted over the course of three experimental sessions. In the first session, one eye of each subject was fitted with a silicone hydrogel contact lens, and the other eye served as the control.

Corneal nerve tortuosity in diabetic patients with neuropathy.

Purpose: Corneal confocal microscopy is a reiterative, rapid, noninvasive in vivo clinical examination technique capable of imaging corneal nerve fibers. Nerve fiber tortuosity may indicate a degenerative and attempted regenerative response of nerve fibers to diabetes. The purpose of this study was to define alterations in the tortuosity of corneal nerve fibers in relation to age, duration of diabetes, glycemic control, and neuropathic severity.