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. 2023 Jul;44(7):2509-2516.
doi: 10.1007/s10072-023-06711-1. Epub 2023 Mar 1.

Corneal nerve fiber involvement in chronic inflammatory demyelinating polyneuropathy

Ezgi Keskiner-Ozturk  1 , Semra Akkaya-Turhan  2 , Ebru Toker  2 , Kayihan Uluc  3 , Hande Alibas  4 , Tulin Tanridag  5 , Pinar Kahraman-Koytak  3
Affiliations

Corneal nerve fiber involvement in chronic inflammatory demyelinating polyneuropathy

Ezgi Keskiner-Ozturk et al. Neurol Sci. 2023 Jul.

Erratum in

Abstract

Background: Despite the primary myelin-related pathophysiology, small fiber neuropathy (SFN) and axonal degeneration are also considered to be involved and associated with disabling symptoms and impaired quality of life in chronic inflammatory demyelinating polyneuropathy (CIDP). Demonstration of SFN usually requires complex or invasive investigations.

Objects: In vivo corneal confocal microscopy (IVCCM) has evolved as a non-invasive, easily applied method for quantification of small fiber involvement in peripheral nerve disorders. We aimed to investigate the potential role of IVCCM in CIDP.

Methods: In this cross-sectional study, 15 patients with CIDP underwent assessment with clinical disability scales, neuropathic pain (NP) and autonomic symptom questionnaires, nerve conduction studies, and IVCCM. IVCCM parameters were analyzed and compared to those from 32 healthy controls.

Results: Corneal nerve fiber density (CNFD) and corneal nerve fiber length (CNFL) were significantly decreased in the CIDP group, compared to those in controls (p = 0.03 and p = 0.024, respectively). Langerhans cells and fiber tortuosity were increased in CIDP patients (p = 0.005 and p = 0.001, respectively). IVCCM parameters were significantly lower in patients with NP compared to those in patients without NP.

Conclusion: IVCCM shows promise as a non-invasive complementary biomarker in the assessment of demyelinating polyneuropathies, providing insights into the potential pathophysiology of these non-length-dependent neuropathies.

Keywords: Corneal confocal microscopy; Inflammatory polyneuropathy; Neuropathic pain; Small fiber.

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