Universität zu Köln

Bucher, Franziska, Schneider, Christian, Blau, Tobias, Cursiefen, Claus, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Lehmann, Helmar C. and Heindl, Ludwig M. (2015). Small-Fiber Neuropathy Is Associated With Corneal Nerve and Dendritic Cell Alterations: An In Vivo Confocal Microscopy Study. Cornea, 34 (9). S. 1114 - 1120. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-4798

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Abstract

Purpose:In patients with small-fiber neuropathy (SFN), noninvasive diagnostic tests that allow accurate monitoring of disease progression are urgently needed. The aim of this study was to assess corneal trigeminal small sensory nerves and immune cells by in vivo corneal confocal microscopy (CCM) in SFN.Methods:In this prospective single-center study, 14 patients with histologically confirmed SFN were analyzed. CCM parameters [corneal nerve fiber density (NFD); the total number of nerves, main trunks, and branches; nerve tortuosity; and dendritic cell density] were compared with 14 age-matched healthy controls and correlated with clinical symptoms, disease course, and histopathological findings.Results:Corneal NFD (15,489.3 5927.6 m/mm(2) vs. 22,687.1 +/- 4328.7 m/mm(2); P = 0.001) and the total number of nerves (10.4 +/- 4.6/frame vs. 18.5 +/- 4.8/frame; P < 0.0001) were significantly reduced in patients with SFN. In contrast, nerve tortuosity was significantly increased (2.2 +/- 0.3 vs. 1.7 +/- 0.5; P = 0.02). Corneal NFD did not correlate with intraepidermal NFD ( = -0.158; P = 0.5) or clinical symptoms (cold P = 0.1; prickling P = 0.2; burning P = 0.8; formication P = 0.7; stabbing P = 0.4; rubbing 0.1; pressure P = 0.1). The average dendritic cell density was increased in SFN (33.5 +/- 57.5 cells/mm(2) vs. 16.1 +/- 13.7 cells/mm(2)) but did not reach significance (P = 0.7).Conclusions:CCM provides parameters that reliably indicate injury to sensory afferents of the trigeminal nerve in patients with SFN. Our data suggest that CCM may serve both as a noninvasive diagnostic test and as a surrogate marker in SFN.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bucher, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Blau, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Lehmann, Helmar C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-395304
DOI:	10.1097/ICO.0000000000000535
Journal or Publication Title:	Cornea
Volume:	34
Number:	9
Page Range:	S. 1114 - 1120
Date:	2015
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-4798
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SKIN BIOPSY; DAMAGE; INFLAMMATION; INNERVATION; DIAGNOSE Multiple languages Ophthalmology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39530