Corneal Confocal Microscopy to Assess Diabetic Neuropathy: An Eye on the Foot
Corneal Confocal Microscopy to Assess Diabetic Neuropathy: An Eye on the Foot
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角膜共聚焦显微镜评估糖尿病神经病变：关注足部
DOI：
10.1177/193229681300700509
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发表时间：
2013
影响因子：
5
通讯作者：
R. Malik
中科院分区：
文献类型：
--
作者：
M. Tavakoli;I. Petropoulos;R. Malik
人类糖尿病周围神经病变的准确检测和定量对于确定高危患者、预测恶化和评估新疗法非常重要。易于执行的临床技术，如神经系统检查、振动感知评估或对10 g单丝不敏感性评估，仅评估晚期神经病变，即，危险的脚评估早期神经病变的技术包括神经生理学（仅评估大纤维）和定量感觉测试（评估小纤维），但它们可能是高度主观的，而更客观的技术，如表皮内神经纤维密度定量的皮肤活检，是侵入性的，并不广泛使用。角膜共聚焦显微镜的新兴眼科技术允许量化角膜神经形态，并使临床医生能够诊断糖尿病患者的周围神经病变，量化其严重程度，并可能评估治疗获益。本综述对原理进行了详细的评论，提供了捕获图像的实用方法，以及分析和解释图像的基础。我们还严格评估了这种新的非侵入性眼科检查诊断糖尿病和其他周围神经病变的诊断能力。
Accurate detection and quantification of human diabetic peripheral neuropathy are important to define at-risk patients, anticipate deterioration, and assess new therapies. Easily performed clinical techniques such as neurological examination, assessment of vibration perception or insensitivity to the 10 g monofilament only assess advanced neuropathy, i.e., the at-risk foot. Techniques that assess early neuropathy include neurophysiology (which assesses only large fibers) and quantitative sensory testing (which assesses small fibers), but they can be highly subjective while more objective techniques, such as skin biopsy for intra-epidermal nerve fiber density quantification, are invasive and not widely available. The emerging ophthalmic technique of corneal confocal microscopy allows quantification of corneal nerve morphology and enables clinicians to diagnose peripheral neuropathy in diabetes patients, quantify its severity, and potentially assess therapeutic benefit. The present review provides a detailed critique of the rationale, a practical approach to capture images, and a basis for analyzing and interpreting the images. We also critically evaluate the diagnostic ability of this new noninvasive ophthalmic test to diagnose diabetic and other peripheral neuropathies.
影响因子：
4.4
作者：
T. Møller-Pedersen;H. Li;W. Petroll;H. Cavanagh;James V. Jester;James V. Jester
通讯作者：
T. Møller-Pedersen;H. Li;W. Petroll;H. Cavanagh;James V. Jester;James V. Jester
影响因子：
4.4
作者：
Davidson, Eric P.;Coppey, Lawrence J.;Yorek, Mark A.
通讯作者：
Yorek, Mark A.
影响因子：
4.4
作者：
Davidson, Eric P.;Coppey, Lawrence J.;Yorek, Mark A.
通讯作者：
Yorek, Mark A.