Corneal confocal microscopy to assess diabetic neuropathy: An eye on the foot Review uri icon


MeSH Major

  • Cornea
  • Diabetic Foot
  • Diabetic Neuropathies
  • Early Diagnosis
  • Microscopy, Confocal


  • 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 neuro-logical 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.

publication date

  • January 2013



  • Review



  • eng

PubMed Central ID

  • PMC3876361

Digital Object Identifier (DOI)

  • 10.1177/193229681300700509

PubMed ID

  • 24124944

Additional Document Info

start page

  • 1179

end page

  • 89


  • 7


  • 5